Provider Demographics
NPI:1780900894
Name:ZAVOS, DOUGLAS SCOTT (AUD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:SCOTT
Last Name:ZAVOS
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13967 W GRAND AVE
Mailing Address - Street 2:#105
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3732
Mailing Address - Country:US
Mailing Address - Phone:623-266-3003
Mailing Address - Fax:623-572-0237
Practice Address - Street 1:13967 W GRAND AVE
Practice Address - Street 2:#105
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3732
Practice Address - Country:US
Practice Address - Phone:623-266-3003
Practice Address - Fax:623-572-0237
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1919237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter