Healthcare Provider Details

I. General information

NPI: 1588368914
Provider Name (Legal Business Name): ZACHARY ERICKSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8414 NAAB RD
INDIANAPOLIS IN
46260-1972
US

IV. Provider business mailing address

8414 NAAB RD
INDIANAPOLIS IN
46260-1972
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-7510
  • Fax: 317-338-7494
Mailing address:
  • Phone: 317-338-7510
  • Fax: 317-338-7494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01099086A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: