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NPI Code Detail

MEDICARE: DR. RANDALL CURTIS ZERNZACH MD

MEDICARE: DR. RANDALL CURTIS ZERNZACH 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
12080P0006XDevelopmental - Behavioral Pediatrics Physician125677AK

General Provider Information

NPI Number : 1730175662
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDALL CURTIS ZERNZACH MD
Provider Business Mailing Address
First Line : 4441 DIPLOMACY DR FL 5
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5910
Country : US
Telephone Number : 907-729-4205
Fax Number : 907-729-8718
Provider Business Practice Location Address
First Line : 4441 DIPLOMACY DR FL 5
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5910
Country : US
Telephone Number : 907-729-4205
Fax Number : 907-729-8718
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 09/27/2021

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