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Individual

ASSADOLLAH ZAINALI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
315 W 15TH ST, LIBERAL, KS 67901-2455
(620) 624-1651
Mailing address
PO BOX 1024, WICHITA, KS 67201-1024
(316) 685-6236

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
04-18506
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000U1995
NM
01
001282
BCBS
KS
05
100029640A
OK
05
100193280A
KS
01
300022970
RAILROAD MEDICARE
Enumeration date
01/28/2006
Last updated
12/02/2013
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