Healthcare Provider Details

I. General information

NPI: 1457922924
Provider Name (Legal Business Name): OSCAR YASSER PENA ZAPATA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 SMITH AVE
THOMASVILLE GA
31792-5533
US

IV. Provider business mailing address

334 SMITH AVE
THOMASVILLE GA
31792-5533
US

V. Phone/Fax

Practice location:
  • Phone: 229-227-1595
  • Fax: 800-272-6512
Mailing address:
  • Phone: 229-227-1595
  • Fax: 800-272-6512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number111770
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: