Provider Demographics
NPI:1508021502
Name:BAIR, ZACHARY CARL (DO)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:CARL
Last Name:BAIR
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 1:28112 N 114TH WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-5694
Mailing Address - Country:US
Mailing Address - Phone:480-659-3907
Mailing Address - Fax:
Practice Address - Street 1:1660 S ALMA SCHOOL RD
Practice Address - Street 2:#213
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3069
Practice Address - Country:US
Practice Address - Phone:480-456-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-20
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005245207P00000X
NY247206207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine