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General NPI Number Information
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NPI Number | 1194712794
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Entity Type | Individual
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Provider Name | PHILLIP B ZARICOR CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 04/25/2017
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Provider Practice Location Address
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Address Line | 5 MOBILE INFIRMARY CIR
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City | MOBILE
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State | AL
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Zip | 36607-3513
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Country | US
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Telephone | 251-432-4497
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Fax | 251-432-0577
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Provider Business Mailing Address
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Address Line | PO BOX 55310
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City | BIRMINGHAM
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State | AL
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Zip | 35255-5310
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Country | US
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Telephone | 205-731-9701
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Fax | 205-297-9411
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 1-084503
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1084503
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License Number State | AL
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