Provider Demographics
NPI:1669812855
Name:FLYNN, ZACHARY ANTHONY (DPM)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:ANTHONY
Last Name:FLYNN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11209 N TATUM BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3000
Mailing Address - Country:US
Mailing Address - Phone:602-973-3888
Mailing Address - Fax:602-973-3028
Practice Address - Street 1:11209 N TATUM BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3000
Practice Address - Country:US
Practice Address - Phone:602-973-3888
Practice Address - Fax:602-973-3028
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0827213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery