Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A148837 | CA |
N | 208600000X | Surgeon | A148837 | CA |
N | 208200000X | Surgeon | IP1384 | KY |
N | 208600000X | Surgeon | IP1384 | KY |
N | 208200000X | Surgeon | R3116 | KY |
N | 208600000X | Surgeon | R3116 | KY |
N | 2086S0102X | Surgical Critical Care | 52757 | KY |
Y | 2086S0127X | Trauma Surgeon | 52757 | KY |
NPI | 1225396799 |
---|---|
Provider Name | Zachary Douglas Warriner |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Lexington, KY 40536-0284 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2012 |
Last Update Date | 30/07/2019 |