Healthcare Provider Details

I. General information

NPI: 1669549127
Provider Name (Legal Business Name): ZACHARY J STENGEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 TENDERFOOT HILL ST
COLORADO SPRINGS CO
80906-3981
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 719-522-1133
  • Fax: 719-226-8669
Mailing address:
  • Phone: 719-538-2900
  • Fax: 719-538-2987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberNM2006-0607
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDR.0058834
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: