Individual
MR. JED DEAN ZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
801 GOODYEAR BLVD, PICAYUNE, MS 39466-3221
(601) 798-4711
Mailing address
26 N HILL DR W, CARRIERE, MS 39426-8147
(601) 749-5976
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R867178
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01689315
—
MS
01
—
336508YYGZ
MEDICARE
MS
Enumeration date
02/26/2007
Last updated
01/15/2019
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