Healthcare Provider Details

I. General information

NPI: 1427314061
Provider Name (Legal Business Name): KRISTON DROUANT ZAKHARY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KRISTON LEIGH DROUANT

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19829 N 27TH AVE
PHOENIX AZ
85027
US

IV. Provider business mailing address

19829 N 27TH AVE
PHOENIX AZ
85027-4001
US

V. Phone/Fax

Practice location:
  • Phone: 623-879-5288
  • Fax: 623-879-1563
Mailing address:
  • Phone: 623-879-5288
  • Fax: 623-879-1563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34379
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number34379
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number55750
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: