Provider Demographics
NPI:1295447985
Name:ZTMANESTHESIA PLLC
Entity type:Organization
Organization Name:ZTMANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLLC MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MESKO
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:479-216-2031
Mailing Address - Street 1:174 POLK ROAD 733
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-8345
Mailing Address - Country:US
Mailing Address - Phone:479-216-2031
Mailing Address - Fax:
Practice Address - Street 1:174 POLK ROAD 733
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-8345
Practice Address - Country:US
Practice Address - Phone:479-216-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty