Individual
ZACHARY MYLES NOLLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5401 N PORTLAND AVE STE 600, OKLAHOMA CITY, OK 73112-2121
(405) 713-9940
(405) 713-9941
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 713-9940
(405) 713-9941
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5257
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200637840 A
—
OK
Enumeration date
04/12/2011
Last updated
05/28/2020
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