Basic Information
| Provider Information | |||||||||
| NPI: | 1396795704 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZARZAUR | ||||||||
| FirstName: | BEN | ||||||||
| MiddleName: | LOUIS | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7974 UW HEALTH CT | ||||||||
| Address2: | |||||||||
| City: | MIDDLETON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 535625531 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537921212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6082637502 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 01/13/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/13/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 01073675A | IN | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 70988 | WI | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | 01073675A | IN | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | 31943 | TN | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 2086S0127X | 70988 | WI | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
ID Information
| ID | Type | State | Issuer | Description | 201219990 | 05 | IN | MEDICAID |