Individual
DR. CHARLES JEFFREY ZOLLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 356-5401
(208) 356-3111
Mailing address
393 E 2ND N, REXBURG, ID 83440-1605
(208) 356-5401
(208) 356-3111
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
M4211
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004021800
—
ID
Enumeration date
08/19/2006
Last updated
04/14/2020
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