| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ZACHARY LINDY WHITAKER | 1205457603 | 2024-11-08 |
Zachary Lindy Whitaker is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1205457603. Registration indicates Zachary Lindy Whitaker is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Dr. Zachary Lindy Whitaker DO |
| Practice Office Address | 19389 N 59TH AVE GLENDALE, AZ US |
| Practice Office Telephone | 6235376000 |
| Practice Office Fax | 6235376014 |
| Mailing Address | 19389 N 59TH AVE GLENDALE, AZ 853086500 US |
| Business Telephone | 6235376000 |
| Business Fax | 6235376014 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |
AZ |