Healthcare Provider Details

I. General information

NPI: 1013546340
Provider Name (Legal Business Name): ZACHARY SCOTT HINGER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 E OAK AVE
FLAGSTAFF AZ
86001-1818
US

IV. Provider business mailing address

851 POINTE VISTA CIR
CORONA CA
92881-3968
US

V. Phone/Fax

Practice location:
  • Phone: 928-779-7880
  • Fax:
Mailing address:
  • Phone: 951-547-9913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7845
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number7845
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: