Healthcare Provider Details

I. General information

NPI: 1013995240
Provider Name (Legal Business Name): JAY SPENCER ZURFLUH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7455 W WASHINGTON AVE #160
LAS VEGAS NV
89128-4337
US

IV. Provider business mailing address

7455 W WASHINGTON AVE #160
LAS VEGAS NV
89128-4337
US

V. Phone/Fax

Practice location:
  • Phone: 702-878-0393
  • Fax: 702-938-0135
Mailing address:
  • Phone: 702-878-0393
  • Fax: 702-938-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA713
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: