Basic Information
| Provider Information | |||||||||
| NPI: | 1679542179 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZIBNERS | ||||||||
| FirstName: | HARRY | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1523 | ||||||||
| Address2: | |||||||||
| City: | LIMA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458021523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192245707 | ||||||||
| FaxNumber: | 4192290040 | ||||||||
| Practice Location | |||||||||
| Address1: | 1241 RIVER VALLEY BLVD | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 431301653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406546312 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2006 | ||||||||
| LastUpdateDate: | 08/29/2008 | ||||||||
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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 | 2085R0202X | 35.030200 | OH | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | C30451 | CA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 00C304510 | 05 | CA | MEDICAID | 2334021 | 05 | OH | MEDICAID |