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General NPI Number Information
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NPI Number | 1225084890
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Entity Type | Organization
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Legal Business Name | GARY B ZOELLNER MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 1501 W 24TH ST SUITE 204
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City | YUMA
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State | AZ
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Zip | 85364-6370
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Country | US
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Telephone | 928-726-5054
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Fax | 928-314-0885
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Provider Business Mailing Address
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Address Line | 1501 W 24TH ST SUITE 204
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City | YUMA
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State | AZ
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Zip | 85364-6370
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Country | US
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Telephone | 928-726-5054
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Fax | 928-314-0885
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GARY BERNARD ZOELLNER
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Credential | MD
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Telephone | 928-726-5054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 30437
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License Number State | AZ
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