Provider Demographics
NPI:1851886394
Name:DR MICHAEL S. ZALESKI
Entity Type:Organization
Organization Name:DR MICHAEL S. ZALESKI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:ZALESKI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:601-268-0400
Mailing Address - Street 1:PO BOX 16235
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-6235
Mailing Address - Country:US
Mailing Address - Phone:601-268-0400
Mailing Address - Fax:601-264-3150
Practice Address - Street 1:123 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PETAL
Practice Address - State:MS
Practice Address - Zip Code:39465-2331
Practice Address - Country:US
Practice Address - Phone:601-268-0400
Practice Address - Fax:601-264-3150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty