Provider Demographics
NPI:1053491050
Name:CHOWDHURY-JACKSON, ZEENAT (MD)
Entity type:Individual
Prefix:DR
First Name:ZEENAT
Middle Name:
Last Name:CHOWDHURY-JACKSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ZEENAT
Other - Middle Name:
Other - Last Name:CHOWDHURY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:839 W CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2819
Mailing Address - Country:US
Mailing Address - Phone:520-670-3909
Mailing Address - Fax:520-309-2560
Practice Address - Street 1:1500 W COMMERCE CT BLDG 1
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-6074
Practice Address - Country:US
Practice Address - Phone:520-670-3909
Practice Address - Fax:520-309-2560
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8080207R00000X
AZ28573207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ790510Medicaid
AZH52484Medicare UPIN