Provider Demographics
NPI:1871569145
Name:ZAFONTE, ROSS DENNIS (DO)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:DENNIS
Last Name:ZAFONTE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:315 W BUSINESS LOOP 70
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3248
Practice Address - Country:US
Practice Address - Phone:573-882-3101
Practice Address - Fax:573-884-4540
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR8N912081P0301X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE53937Medicare UPIN
PA101105476Medicare ID - Type Unspecified
PA469345JX3Medicare ID - Type Unspecified