Healthcare Provider Details

I. General information

NPI: 1316137169
Provider Name (Legal Business Name): ZAFFAR IQBAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2007
Last Update Date: 02/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 STOCKTON HILL RD SUITE 1
KINGMAN AZ
86409-0514
US

IV. Provider business mailing address

3636 STOCKTON HILL RD SUITE 1
KINGMAN AZ
86409-0514
US

V. Phone/Fax

Practice location:
  • Phone: 928-757-8440
  • Fax: 928-757-5460
Mailing address:
  • Phone: 928-757-8440
  • Fax: 928-757-5460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number32218
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: