Provider Demographics
NPI:1912965682
Name:STEARNS, ZACK R (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACK
Middle Name:R
Last Name:STEARNS
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 1:7926 PRESTON HWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-3848
Mailing Address - Country:US
Mailing Address - Phone:502-645-4456
Mailing Address - Fax:
Practice Address - Street 1:7926 PRESTON HWY
Practice Address - Street 2:SUITE 103
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-3848
Practice Address - Country:US
Practice Address - Phone:502-645-4456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26811207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100323960Medicaid
KY64268113Medicaid
KYP01591073OtherRAILROAD MEDICARE
KY50101238OtherPASSPORT HEALTH PLAN
KY64268113Medicaid
IN100323960Medicaid
KYB65204Medicare UPIN
KY64268113Medicaid
000052152XOtherNOTC/HUMANA
KY1612201Medicare ID - Type Unspecified