Healthcare Provider Details

I. General information

NPI: 1841729431
Provider Name (Legal Business Name): KENNETH S ZURCHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2017
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22455 N MILLER RD # B100
SCOTTSDALE AZ
85255-4956
US

IV. Provider business mailing address

22455 N MILLER RD # B100
SCOTTSDALE AZ
85255-4956
US

V. Phone/Fax

Practice location:
  • Phone: 480-725-0945
  • Fax:
Mailing address:
  • Phone: 480-725-0945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2085R0202X
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number56935
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR76343
License Number StateAZ
# 4
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number56935
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: