Provider Demographics
NPI:1467827931
Name:ZACK R STEARNS MD ORTHOPEDIC BONE & JOINT SPECIALISTS PLLC
Entity Type:Organization
Organization Name:ZACK R STEARNS MD ORTHOPEDIC BONE & JOINT SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACK
Authorized Official - Middle Name:R
Authorized Official - Last Name:STEARNS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-645-4456
Mailing Address - Street 1:7926 PRESTON HWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-3848
Mailing Address - Country:US
Mailing Address - Phone:502-645-4456
Mailing Address - Fax:
Practice Address - Street 1:7926 PRESTON HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-3848
Practice Address - Country:US
Practice Address - Phone:502-645-4456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYDW2567OtherRAILROAD MEDICARE
IN201389900Medicaid
KY50101237OtherPASSPORT HEALTH PLAN
KY7100395270Medicaid
KY50101237OtherPASSPORT HEALTH PLAN