1093857500 NPI number — DR. JAMES A ZEIGLER JR. AU.D.

Table of content: DR. JAMES A ZEIGLER JR. AU.D. (NPI 1093857500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093857500 NPI number — DR. JAMES A ZEIGLER JR. AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZEIGLER
Provider First Name:
JAMES
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
AU.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093857500
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 3RD AVE
Provider Second Line Business Mailing Address:
SUITE 109
Provider Business Mailing Address City Name:
KINGSTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18704-5816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-714-2656
Provider Business Mailing Address Fax Number:
570-714-2799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
403 3RD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINGSTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18704-5802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-714-2656
Provider Business Practice Location Address Fax Number:
570-714-2799
Provider Enumeration Date:
02/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  AT-000-191-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X , with the licence number: AT-000-191-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1587985 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 206892TOP . This is a "BC-BS FREEDOM BLUE PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1587985 . This is a "PEBTF-BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 819309 . This is a "HMO 1ST PRIORITY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017419370004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0017419370003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1587985 . This is a "BC-BS PPO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 171322 . This is a "UNISON-MED PLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com