Basic Information
| Provider Information | |||||||||
| NPI: | 1609036375 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZIETLOW | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
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| Credential: | MD PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1155 W JEFFERSON ST | ||||||||
| Address2: | STE 104 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461312731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178343263 | ||||||||
| FaxNumber: | 3178345194 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 HADLEY RD | ||||||||
| Address2: | |||||||||
| City: | MOORESVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461581737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3178343263 | ||||||||
| FaxNumber: | 3178345194 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2008 | ||||||||
| LastUpdateDate: | 07/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35-090815 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 01065671A | IN | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.