Basic Information
| Provider Information | |||||||||
| NPI: | 1669500948 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZALINSKI | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 MEDICAL PARK DR | ||||||||
| Address2: | |||||||||
| City: | HARTSVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295504765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433833742 | ||||||||
| FaxNumber: | 8433833745 | ||||||||
| Practice Location | |||||||||
| Address1: | 824 ILLINOIS AVENUE | ||||||||
| Address2: | |||||||||
| City: | STEVENS POINT | ||||||||
| State: | WI | ||||||||
| PostalCode: | 54481 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7153427500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 05/20/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | TL2532 | SC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 42946200 | 05 | WI | MEDICAID |