Provider Demographics
NPI:1902092992
Name:ZINK, EZEKIAS JOHN (PA-C)
Entity Type:Individual
Prefix:
First Name:EZEKIAS
Middle Name:JOHN
Last Name:ZINK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4344 W BELL RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-3589
Mailing Address - Country:US
Mailing Address - Phone:602-588-4040
Mailing Address - Fax:602-588-4034
Practice Address - Street 1:4344 W BELL RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-3589
Practice Address - Country:US
Practice Address - Phone:602-588-4040
Practice Address - Fax:602-588-4034
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ3689363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical