John S Zavacki, M.D.,P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD009136-E Issued in PA

Legal business name

JOHN S ZAVACKI, M.D.,P.C.

Practice address

216 N River St
Suite 640 Courthouse Square Towers
Wilkes Barre, PA 18702-2532

Phone

(570) 829-0031

Fax

(570) 829-0158

NPI assigned

Sep 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John S Zavacki, M.D.

Title

President

Phone

(570) 829-0031

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1770770497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N RIVER ST",
            "address_2": "SUITE 640 COURTHOUSE SQUARE TOWERS",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187022532",
            "telephone_number": "570-829-0031",
            "fax_number": "570-829-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N RIVER ST",
            "address_2": "SUITE 640 COURTHOUSE SQUARE TOWERS",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187022532",
            "telephone_number": "570-829-0031",
            "fax_number": "570-829-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN S ZAVACKI, M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "ZAVACKI",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-829-0031",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD009136-E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "ZA1635348",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.