Basic Information
| Provider Information | |||||||||
| NPI: | 1740578780 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARTON | ||||||||
| FirstName: | ZACHARY | ||||||||
| MiddleName: | W. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 E STAR CT | ||||||||
| Address2: | |||||||||
| City: | MONTROSE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 814016702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702400378 | ||||||||
| FaxNumber: | 9702403346 | ||||||||
| Practice Location | |||||||||
| Address1: | 816 S 5TH ST | ||||||||
| Address2: | |||||||||
| City: | MONTROSE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702493322 | ||||||||
| FaxNumber: | 9702407976 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2011 | ||||||||
| LastUpdateDate: | 05/16/2018 | ||||||||
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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 | 207Q00000X | BP10041425 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | DR.0053523 | CO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 347816YTYK | 01 | CO | MEDICARE PTAN SAN JUAN FAMILY MEDICINE | OTHER | 347816YTYK | 01 | CO | CEDAR POINT HEALTH, LLC | OTHER | 75839261 | 05 | CO | MEDICAID |