Provider Demographics
NPI:1326242041
Name:ZOLLINGER, JEFFREY S (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:ZOLLINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 ELM ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4522
Mailing Address - Country:US
Mailing Address - Phone:775-870-1480
Mailing Address - Fax:775-870-1630
Practice Address - Street 1:343 ELM ST STE 202
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4538
Practice Address - Country:US
Practice Address - Phone:775-870-1480
Practice Address - Fax:877-764-6351
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1624208VP0000X, 208VP0000X
FLOS10927208VP0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN250000759Medicare PIN
FLDG130ZMedicare PIN