Basic Information
| Provider Information | |||||||||
| NPI: | 1033781877 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KIMBERLY ZASLOW DO, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 756 | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975200026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5413015843 | ||||||||
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| Practice Location | |||||||||
| Address1: | 850 SISKIYOU BLVD STE 7 | ||||||||
| Address2: | |||||||||
| City: | ASHLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975202125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5414820342 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2021 | ||||||||
| LastUpdateDate: | 07/12/2021 | ||||||||
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| AuthorizedOfficialLastName: | ZASLOW | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 5413015843 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | 07/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.