1679851828 NPI number — DR. JENNA LORRAINE ZIGLER O.D.

Table of content: DR. JENNA LORRAINE ZIGLER O.D. (NPI 1679851828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679851828 NPI number — DR. JENNA LORRAINE ZIGLER O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIGLER
Provider First Name:
JENNA
Provider Middle Name:
LORRAINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STELZER
Provider Other First Name:
JENNA
Provider Other Middle Name:
LORRAINE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
O.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1679851828
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
206 FRANKFORT SQ
Provider Second Line Business Mailing Address:
COLUMBUS
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43206-1059
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-425-8354
Provider Business Mailing Address Fax Number:
614-876-6311

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5200 WEST POINTE PLAZA
Provider Second Line Business Practice Location Address:
COLUMBUS
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-876-6747
Provider Business Practice Location Address Fax Number:
614-876-6311
Provider Enumeration Date:
07/21/2011

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: 152W00000X , with the licence number:  6076 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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