Individual
DR. GREGORY STANLEY ZOLKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
910 E SAN MARTIN ST, BOLIVAR, MO 65613-2893
(417) 777-4749
(417) 777-8041
Mailing address
PO BOX 536, BOLIVAR, MO 65613-0536
(417) 777-4749
(417) 777-8041
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E-11776
AR
207Q00000X
Family Medicine Physician
Primary
101186
MO
207Q00000X
Family Medicine Physician
E-11776
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619959145
—
MO
05
—
244710802
—
MO
01
—
P00786258
RR MEDICARE
—
Enumeration date
11/18/2005
Last updated
03/13/2020
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