Provider Demographics
NPI:1730150756
Name:A ZAINALI MD RADIOLOGY PA
Entity type:Organization
Organization Name:A ZAINALI MD RADIOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASSADOLLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAINALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:620-624-1651
Mailing Address - Street 1:PO BOX 1024
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-1024
Mailing Address - Country:US
Mailing Address - Phone:316-685-6236
Mailing Address - Fax:
Practice Address - Street 1:315 W 15TH ST
Practice Address - Street 2:
Practice Address - City:LIBERAL
Practice Address - State:KS
Practice Address - Zip Code:67901-2455
Practice Address - Country:US
Practice Address - Phone:620-624-1651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-28
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS111278Medicare PIN
CS1641Medicare PIN