Provider Demographics
NPI:1265056220
Name:FROST, WYN ZHANG (DO)
Entity type:Individual
Prefix:DR
First Name:WYN
Middle Name:ZHANG
Last Name:FROST
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:WYN
Other - Middle Name:ZHANG
Other - Last Name:CROMWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 31235
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85751-1235
Mailing Address - Country:US
Mailing Address - Phone:520-324-2308
Mailing Address - Fax:520-324-1406
Practice Address - Street 1:10350 E DREXEL RD UNIT 110
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-9409
Practice Address - Country:US
Practice Address - Phone:520-324-1727
Practice Address - Fax:520-324-1406
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR3398390200000X
AZ010264208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program