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General NPI Number Information
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NPI Number | 1386090702
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Entity Type | Individual
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Provider Name | JOSEPH DESSAIX ZACHARY M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | CARL A. JONES HALL, VA BUILDING 1 DOGWOOD AVE
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City | MOUNTAIN HOME
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State | TN
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Zip | 37684
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Country | US
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Telephone | 423-439-6283
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100374
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City | GAINESVILLE
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State | FL
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Zip | 32610-0374
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Country | US
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Telephone | 352-265-0438
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Fax |
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | ME151379
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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