Healthcare Provider Details

I. General information

NPI: 1386729580
Provider Name (Legal Business Name): DARRELL J ZEHR D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 BIRCH STREET
DEKALB MS
39328
US

IV. Provider business mailing address

2710 DAVIS STREET
MERIDIAN MS
39301-5708
US

V. Phone/Fax

Practice location:
  • Phone: 601-693-0118
  • Fax: 601-553-8175
Mailing address:
  • Phone: 601-693-0118
  • Fax: 601-553-8175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number5348
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3318-07
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: