Basic Information
Provider Information
NPI: 1427582923
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZUMBAUGH
FirstName: THOMAS
MiddleName: ALAN
NamePrefix:  
NameSuffix:  
Credential: DPM
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2300 PLEASANT VALLEY RD
Address2:  
City: YORK
State: PA
PostalCode: 174029627
CountryCode: US
TelephoneNumber: 7177573537
FaxNumber:  
Practice Location
Address1: 2300 PLEASANT VALLEY RD
Address2:  
City: YORK
State: PA
PostalCode: 174029627
CountryCode: US
TelephoneNumber: 7177573537
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/12/2017
LastUpdateDate: 06/10/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213E00000XSC006842PAY Podiatric Medicine & Surgery Service ProvidersPodiatrist 

No ID Information.


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