MEDICARE: KENNETH J ZOOK PA-C

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	363AS0400X	Surgical Physician Assistant	MA052992	PA

General Provider Information

NPI Number	:	1972708543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH J ZOOK PA-C

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 JPM RD STE 300
Second Line	:
City	:	LEWISBURG
State	:	PA
Zip	:	17837-9367
Country	:	US
Telephone Number	:	570-524-4446
Fax Number	:	570-522-1110

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

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	03/30/2026

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