Basic Information
| Provider Information | |||||||||
| NPI: | 1386686988 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OZKAZANC | ||||||||
| FirstName: | ISMET | ||||||||
| MiddleName: | BEHZAT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 860 BETHESDA DR | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437011800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404544651 | ||||||||
| FaxNumber: | 7404544653 | ||||||||
| Practice Location | |||||||||
| Address1: | 1210 ASHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437012806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404548551 | ||||||||
| FaxNumber: | 7404542411 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2006 | ||||||||
| LastUpdateDate: | 11/09/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35-07-2715-O | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0989499 | 05 | OH | MEDICAID | CA0426 | 01 | GROUP MEDICARE PTAN | OTHER | 9270902 | 01 | OH | GROUP MEDICARE | OTHER | 2042819 | 05 | OH | MEDICAID | P00220243 | 01 | OH | RAILROAD MEDICARE | OTHER |