Healthcare Provider Details
I. General information
NPI: 1326242041
Provider Name (Legal Business Name): JEFFREY S ZOLLINGER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/14/2007
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4838 SPARKS BLVD STE 102
SPARKS NV
89436-8156
US
IV. Provider business mailing address
4838 SPARKS BLVD STE 102
SPARKS NV
89436-8156
US
V. Phone/Fax
- Phone: 775-870-1480
- Fax: 877-764-6351
- Phone: 775-870-1480
- Fax: 877-764-6351
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2081P2900X |
| Taxonomy | Pain Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | DO1624 |
| License Number State | NV |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | 1624 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: