Provider Demographics
NPI:1578532214
Name:ZACHARY, PAUL E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:ZACHARY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 RESEARCH PARK DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5000
Mailing Address - Country:US
Mailing Address - Phone:785-537-2651
Mailing Address - Fax:
Practice Address - Street 1:1325 RESEARCH PARK DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5000
Practice Address - Country:US
Practice Address - Phone:785-537-2651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0423652207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100310000BMedicaid
KS051899Medicare ID - Type Unspecified
KS100310000BMedicaid