Individual
KELLY JOSEPH ZACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7121 STEPHANIE LN, STE 102, LINCOLN, NE 68516-5359
(402) 413-5010
(402) 413-5009
Mailing address
7121 STEPHANIE LN, STE 102, LINCOLN, NE 68516-5359
(402) 413-5010
(402) 413-5009
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R72483
AZ
208VP0014X
Interventional Pain Medicine Physician
Primary
29166
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R72483
TRAINING PERMIT
AZ
Enumeration date
06/23/2011
Last updated
01/19/2017
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