Provider Demographics
NPI:1346763612
Name:VOLNER, ZACHARY JORDAN I
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JORDAN
Last Name:VOLNER
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 SE LINDSEY ST
Mailing Address - Street 2:
Mailing Address - City:HOXIE
Mailing Address - State:AR
Mailing Address - Zip Code:72433-2224
Mailing Address - Country:US
Mailing Address - Phone:870-886-1333
Mailing Address - Fax:870-886-1334
Practice Address - Street 1:503 SE LINDSEY ST
Practice Address - Street 2:
Practice Address - City:HOXIE
Practice Address - State:AR
Practice Address - Zip Code:72433
Practice Address - Country:US
Practice Address - Phone:870-886-1333
Practice Address - Fax:870-886-1334
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR175330526Medicaid