Provider Demographics
NPI:1740696137
Name:ZLOTNICKI, JASON PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:PAUL
Last Name:ZLOTNICKI
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 1:2345 COURT DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2151
Mailing Address - Country:US
Mailing Address - Phone:704-343-8279
Mailing Address - Fax:
Practice Address - Street 1:2345 COURT DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2151
Practice Address - Country:US
Practice Address - Phone:704-343-8279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-01981207X00000X
PAMT205985207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery