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General NPI Number Information
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NPI Number | 1760905145
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Entity Type | Organization
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Legal Business Name | DR MICHAEL S ZALESKI
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 206 BAY AVE STE A
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City | RICHTON
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State | MS
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Zip | 39476-2941
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Country | US
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Telephone | 601-268-0400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16235
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City | HATTIESBURG
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State | MS
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Zip | 39404-6235
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Country | US
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Telephone | 601-268-0400
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Fax | 601-264-3150
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Authorized Official
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Title or Position | DPM / AUTHORIZED OFFICIAL
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Name | MICHAEL S ZALESKI
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Credential | DPM
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Telephone | 601-268-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 80131
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License Number State | MS
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