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General NPI Number Information
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NPI Number | 1962548149
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Entity Type | Individual
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Provider Name | BRENT A ZAMZOW D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1718 PARR AVE STE A
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City | DYERSBURG
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State | TN
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Zip | 38024-2075
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Country | US
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Telephone | 731-285-4104
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Fax | 731-285-8157
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Provider Business Mailing Address
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Address Line | PO BOX 689022
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City | FRANKLIN
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State | TN
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Zip | 37068-9022
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Country | US
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Telephone | 615-465-3266
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Fax | 615-465-2927
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 2288
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License Number State | TN
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