MEDICARE: ROBERT GEORGE ZENNER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	18691	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	18691	OTHER	AZ	MEDICAL LICENSE

General Provider Information

NPI Number	:	1467445122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT GEORGE ZENNER M.D.

Provider Business Mailing Address
First Line	:	1830 S ALMA SCHOOL RD
Second Line	:	SUITE 134
City	:	MESA
State	:	AZ
Zip	:	85210-3056
Country	:	US
Telephone Number	:	480-839-4085
Fax Number	:	480-730-3312

Provider Business Practice Location Address
First Line	:	1830 S ALMA SCHOOL RD
Second Line	:	SUITE 134
City	:	MESA
State	:	AZ
Zip	:	85210-3056
Country	:	US
Telephone Number	:	480-839-4085
Fax Number	:	480-730-3312

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2005
Last Update Date	:	03/07/2023

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