1902844178 NPI number — CAROLYNN L ZONIA D.O.

Table of content: CAROLYNN L ZONIA D.O. (NPI 1902844178)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902844178 NPI number — CAROLYNN L ZONIA D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZONIA
Provider First Name:
CAROLYNN
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

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:
1902844178
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 BISHOP ST STE 1904
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96813-4102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-369-0179
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BAYNE JONES ARMY COMMUNITY HOSPITAL
Provider Second Line Business Practice Location Address:
1585 THIRD ST
Provider Business Practice Location Address City Name:
FORT POLK
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71459-4815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-531-3363
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/02/2006

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: 207P00000X , with the licence number:  OS13889 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 5101010804 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 036-086002 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 036086002 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 930062809 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".