Healthcare Provider Details

I. General information

NPI: 1255339909
Provider Name (Legal Business Name): LARRY ZONIS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9755 N 90TH ST STE C120
SCOTTSDALE AZ
85258-5046
US

IV. Provider business mailing address

9755 N 90TH ST STE C120
SCOTTSDALE AZ
85258-5046
US

V. Phone/Fax

Practice location:
  • Phone: 480-391-9193
  • Fax: 480-661-6202
Mailing address:
  • Phone: 480-391-9193
  • Fax: 480-661-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number0112
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: