Provider Demographics
NPI:1013984343
Name:ZENZICK, ALEXANDER JON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JON
Last Name:ZENZICK
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 1:7764 JOSEPH PETERS DR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-9013
Mailing Address - Country:US
Mailing Address - Phone:920-527-8086
Mailing Address - Fax:
Practice Address - Street 1:333 N COMMERCIAL ST
Practice Address - Street 2:SUITE 300
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2657
Practice Address - Country:US
Practice Address - Phone:920-527-8086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI46945-020207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology