Provider Demographics
NPI:1013179621
Name:ZIMBELMAN, TRAVIS JASON (DPM)
Entity Type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:JASON
Last Name:ZIMBELMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 MCQUEEN SMITH RD N
Mailing Address - Street 2:SUITE - F
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-7554
Mailing Address - Country:US
Mailing Address - Phone:334-358-8666
Mailing Address - Fax:334-358-8667
Practice Address - Street 1:461 COTTON GIN RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3558
Practice Address - Country:US
Practice Address - Phone:334-557-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL295213EP0504X, 213ER0200X, 213ES0000X, 213ES0103X, 213ES0131X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery