Provider Demographics
NPI:1770876070
Name:NICHOLAS, ZACHARY PEARCE (MD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:PEARCE
Last Name:NICHOLAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 NE 10TH ST
Practice Address - Street 2:OKCC L100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5418
Practice Address - Country:US
Practice Address - Phone:405-271-5641
Practice Address - Fax:405-271-8297
Is Sole Proprietor?:No
Enumeration Date:2011-05-18
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK292772085R0203X
MO20190105022085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology