Provider Demographics
NPI:1689254088
Name:FERRELL, ZACHARY DOUGLAS (DO)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:DOUGLAS
Last Name:FERRELL
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 1:3100 N TENAYA WAY FL 2
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0436
Mailing Address - Country:US
Mailing Address - Phone:702-962-5000
Mailing Address - Fax:702-962-2331
Practice Address - Street 1:3150 N TENAYA WAY STE 455
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0460
Practice Address - Country:US
Practice Address - Phone:801-739-1328
Practice Address - Fax:702-962-2331
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-09
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program