Healthcare Provider Details

I. General information

NPI: 1750737227
Provider Name (Legal Business Name): DR Z GENERAL SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 FORT MISSOULA RD STE 306
MISSOULA MT
59804-7424
US

IV. Provider business mailing address

2835 FORT MISSOULA RD STE 306
MISSOULA MT
59804-7424
US

V. Phone/Fax

Practice location:
  • Phone: 406-541-2570
  • Fax:
Mailing address:
  • Phone: 406-541-2570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number12818
License Number StateMT

VIII. Authorized Official

Name: DR. MICHAEL JOSEPH ZEHNPFENNIG
Title or Position: SURGEON PRACTICE ADMINISTRATOR
Credential: M.D.
Phone: 406-541-2570