MEDICARE: ZYNIA PUA MD

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	207Q00000X	Family Medicine Physician	27514	AL
2	207Q00000X	Family Medicine Physician	47905	TN

General Provider Information

NPI Number	:	1548361280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZYNIA PUA MD

Provider Business Mailing Address
First Line	:	6401 MOUNTAIN VIEW ROAD
Second Line	:	SUITE 109
City	:	OOLTEWAH
State	:	TN
Zip	:	37363-6685
Country	:	US
Telephone Number	:	423-495-5951
Fax Number	:	423-495-5999

Provider Business Practice Location Address
First Line	:	2051 HAMILL RD STE 103
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4653
Country	:	US
Telephone Number	:	423-756-8871
Fax Number	:	423-475-8977

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	06/11/2019

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Directions to “ ZYNIA PUA MD” Practice Location

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