Provider Demographics
NPI:1639112675
Name:ZINGER, JON R (CCP)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:R
Last Name:ZINGER
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27588
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85285-7588
Mailing Address - Country:US
Mailing Address - Phone:480-777-0900
Mailing Address - Fax:480-777-1345
Practice Address - Street 1:5801 S MCCLINTOCK DR
Practice Address - Street 2:110
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-6002
Practice Address - Country:US
Practice Address - Phone:480-777-0900
Practice Address - Fax:490-777-1345
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ902272Medicaid