Basic Information
Provider Information | |||||||||
NPI: | 1255988614 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | ORTHOPAEDIC ASSOCIATES OF ZANESVILLE INC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2854 BELL ST | ||||||||
Address2: |   | ||||||||
City: | ZANESVILLE | ||||||||
State: | OH | ||||||||
PostalCode: | 437011790 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7404543273 | ||||||||
FaxNumber: | 7405881081 | ||||||||
Practice Location | |||||||||
Address1: | 2854 BELL ST | ||||||||
Address2: |   | ||||||||
City: | ZANESVILLE | ||||||||
State: | OH | ||||||||
PostalCode: | 437011790 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7404543273 | ||||||||
FaxNumber: | 7405881081 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/21/2019 | ||||||||
LastUpdateDate: | 02/18/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | SAUNDERS | ||||||||
AuthorizedOfficialFirstName: | KARL | ||||||||
AuthorizedOfficialMiddleName: | C | ||||||||
AuthorizedOfficialTitleorPosition: | COO | ||||||||
AuthorizedOfficialTelephone: | 7404543273 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | Y | ||||||||
ParentOrganizationLBN: | ORTHOPAEDIC ASSOCIATES OF ZANESVILLE INC | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 02/18/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0005X |   |   | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Sports Medicine | 332B00000X |   |   | N |   | Suppliers | Durable Medical Equipment & Medical Supplies |   | 207X00000X |   |   | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |   |
No ID Information.