Provider Demographics
NPI:1316067556
Name:VICTOR J. ZANNIS, M.D., P.C.
Entity type:Organization
Organization Name:VICTOR J. ZANNIS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZANNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-942-8000
Mailing Address - Street 1:2525 W GREENWAY RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-4226
Mailing Address - Country:US
Mailing Address - Phone:602-942-8000
Mailing Address - Fax:602-942-8025
Practice Address - Street 1:2525 W GREENWAY RD
Practice Address - Street 2:SUITE 130
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-4226
Practice Address - Country:US
Practice Address - Phone:602-942-8000
Practice Address - Fax:602-942-8025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10404208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherGROUP TAX ID
=========OtherGROUP TAX ID