Provider Demographics
NPI:1154526549
Name:MORAIRTY, ZACHARY X (MD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:X
Last Name:MORAIRTY
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 1:118 9TH AVE N
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6352
Mailing Address - Country:US
Mailing Address - Phone:208-537-7800
Mailing Address - Fax:208-856-1509
Practice Address - Street 1:118 9TH AVE N
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6352
Practice Address - Country:US
Practice Address - Phone:208-357-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM116642084P0805X
IDM-116642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1154526549Medicaid
MI4976543Medicaid