Provider Demographics
NPI:1962479477
Name:ZAKHARY, MOUNIR GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:MOUNIR
Middle Name:GEORGE
Last Name:ZAKHARY
Suffix:
Gender:M
Credentials:MD
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 975
Mailing Address - Street 2:
Mailing Address - City:ALTUS
Mailing Address - State:OK
Mailing Address - Zip Code:73522-0975
Mailing Address - Country:US
Mailing Address - Phone:580-477-7444
Mailing Address - Fax:580-477-7452
Practice Address - Street 1:304 S PARK LN
Practice Address - Street 2:SUITE B
Practice Address - City:ALTUS
Practice Address - State:OK
Practice Address - Zip Code:73521-5718
Practice Address - Country:US
Practice Address - Phone:580-477-7444
Practice Address - Fax:580-477-7452
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK16307208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD35441Medicare UPIN