Healthcare Provider Details

I. General information

NPI: 1528452091
Provider Name (Legal Business Name): JONATHAN ROBERT ZURCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE BLDG A
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

214 COLONIAL HOMES DR NW UNIT 1506
ATLANTA GA
30309-1589
US

V. Phone/Fax

Practice location:
  • Phone: 803-917-2564
  • Fax:
Mailing address:
  • Phone: 803-917-2564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number95686
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: