Provider Demographics
NPI:1821481292
Name:WEST, ZACHARY KYLE (DO)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:KYLE
Last Name:WEST
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 1:3040 N TOWNSHIP ROAD 155
Mailing Address - Street 2:
Mailing Address - City:TIFFIN
Mailing Address - State:OH
Mailing Address - Zip Code:44883-9508
Mailing Address - Country:US
Mailing Address - Phone:419-618-5338
Mailing Address - Fax:
Practice Address - Street 1:93 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-1522
Practice Address - Country:US
Practice Address - Phone:567-804-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.012669CTR207R00000X, 204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty