Provider Demographics
NPI:1194198200
Name:RITTER, ZACHARY (PA-C)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:RITTER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WOODMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2245
Mailing Address - Country:US
Mailing Address - Phone:615-467-7400
Mailing Address - Fax:
Practice Address - Street 1:1211 CUSHMAN ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4680
Practice Address - Country:US
Practice Address - Phone:559-326-1222
Practice Address - Fax:559-326-1230
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK103905363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant