Provider Demographics
NPI:1013021021
Name:JAMES F ZUMSTEIN MD LLC
Entity Type:Organization
Organization Name:JAMES F ZUMSTEIN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANANGER
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-664-0219
Mailing Address - Street 1:1810 STADIUM DRIVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-3100
Mailing Address - Country:US
Mailing Address - Phone:334-664-0219
Mailing Address - Fax:
Practice Address - Street 1:1810 STADIUM DRIVE
Practice Address - Street 2:SUITE 230
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-3100
Practice Address - Country:US
Practice Address - Phone:334-664-0219
Practice Address - Fax:334-664-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00017633207Q00000X
GA037931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51515341ZUMOtherBCBS
GA52580378-001OtherBCBS
P00009293OtherPALMETTO MEDICARE RAILROA
=========OtherTAX ID
F75587Medicare UPIN