Provider Demographics
NPI:1669094173
Name:BROWN, ZACHARY THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:THOMAS
Last Name:BROWN
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 1:43819 N 20TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW RIVER
Mailing Address - State:AZ
Mailing Address - Zip Code:85087-0967
Mailing Address - Country:US
Mailing Address - Phone:602-910-0579
Mailing Address - Fax:
Practice Address - Street 1:20172 E STAGECOACH TRL
Practice Address - Street 2:
Practice Address - City:MAYER
Practice Address - State:AZ
Practice Address - Zip Code:86333-2357
Practice Address - Country:US
Practice Address - Phone:928-632-4399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ70269207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty