Provider Demographics
NPI:1437844594
Name:BENEFIELD, ZACCARY PHILLIP
Entity type:Individual
Prefix:MR
First Name:ZACCARY
Middle Name:PHILLIP
Last Name:BENEFIELD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 W GALBRAITH RD APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-5594
Mailing Address - Country:US
Mailing Address - Phone:888-847-7262
Mailing Address - Fax:513-672-2771
Practice Address - Street 1:1266 W GALBRAITH RD APT 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-5594
Practice Address - Country:US
Practice Address - Phone:888-847-7262
Practice Address - Fax:513-672-2771
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-05
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUQ690741172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver