Provider Demographics
NPI:1043224397
Name:ZILZ, NATHAN D (MD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:D
Last Name:ZILZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 E FLORENTINE RD STE 206
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-2245
Mailing Address - Country:US
Mailing Address - Phone:928-442-8117
Mailing Address - Fax:
Practice Address - Street 1:7700 E FLORENTINE RD STE 206
Practice Address - Street 2:CARDIOLOGY CLINIC 2ND FLOOR
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-2245
Practice Address - Country:US
Practice Address - Phone:928-442-8117
Practice Address - Fax:928-442-8932
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-16338207RC0000X
AZ52031207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ52031OtherARIZONA LICENSE
AZ52031OtherARIZONA LICENSE