Provider Demographics
NPI:1508872714
Name:SMITH-ZAGONE, MEGAN JENNIFER (MD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:JENNIFER
Last Name:SMITH-ZAGONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-3218
Mailing Address - Country:US
Mailing Address - Phone:707-269-3617
Mailing Address - Fax:707-269-3889
Practice Address - Street 1:2425 HARRISON AVE
Practice Address - Street 2:STE A
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-3218
Practice Address - Country:US
Practice Address - Phone:707-269-3617
Practice Address - Fax:707-269-3889
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA89551207ND0900X, 207ZD0900X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology