Individual
ZACHARY W SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
(920) 224-1706
Mailing address
PO BOX 8031, APPLETON, WI 54912-8031
(866) 313-0337
(920) 224-1706
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
163376
WI
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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