Provider Demographics
NPI:1104004118
Name:KORAN L. ZEHNDER
Entity Type:Organization
Organization Name:KORAN L. ZEHNDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KORAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZEHNDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-343-0145
Mailing Address - Street 1:PO BOX 710
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-0710
Mailing Address - Country:US
Mailing Address - Phone:330-343-0145
Mailing Address - Fax:
Practice Address - Street 1:163 W HIGH AVE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-3840
Practice Address - Country:US
Practice Address - Phone:330-343-0145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2845261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0637730001Medicare NSC