Provider Demographics
NPI:1245887470
Name:ZUEFLE, SCOTT GREGORY
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:GREGORY
Last Name:ZUEFLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 N DRINKWATER BLVD APT A407
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3653
Mailing Address - Country:US
Mailing Address - Phone:716-908-3627
Mailing Address - Fax:
Practice Address - Street 1:1137 S DOBSON RD # 10
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-3902
Practice Address - Country:US
Practice Address - Phone:480-964-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS024204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist