Provider Demographics
NPI:1487933719
Name:PECKLER, ZACHARY JOHN (MD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JOHN
Last Name:PECKLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1015 WALNUT ST.
Mailing Address - Street 2:SUITE 620 CURTIS
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-955-1170
Mailing Address - Fax:215-955-2878
Practice Address - Street 1:2767 OLIVE HWY
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6118
Practice Address - Country:US
Practice Address - Phone:530-533-8500
Practice Address - Fax:530-532-8370
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD445027208600000X
CAA164058208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery