Provider Demographics
NPI:1790787026
Name:ZAKRAJSEK, FRANCIS THOMAS (EMT-B, FF)
Entity Type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:THOMAS
Last Name:ZAKRAJSEK
Suffix:
Gender:M
Credentials:EMT-B, FF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3123 RUBBLE WAY
Mailing Address - Street 2:APT A
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-5473
Mailing Address - Country:US
Mailing Address - Phone:574-870-0669
Mailing Address - Fax:
Practice Address - Street 1:7758 N 800 E
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IN
Practice Address - Zip Code:47960-7452
Practice Address - Country:US
Practice Address - Phone:574-870-0669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN91-59005146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KD4NEKOtherAMATEUR RADIO LICENSE
IN61508OtherFIREFIGHTER, BASIC