Provider Demographics
NPI:1326177049
Name:ZIMMERMAN, JAMES FREDERICK (DPM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:FREDERICK
Last Name:ZIMMERMAN
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 1:550 ROBINSON AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-3651
Mailing Address - Country:US
Mailing Address - Phone:330-753-7700
Mailing Address - Fax:330-753-3971
Practice Address - Street 1:550 ROBINSON AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3651
Practice Address - Country:US
Practice Address - Phone:330-753-7700
Practice Address - Fax:330-753-3971
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002579213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0752261Medicaid
OHP00448473OtherRAILROAD MEDICARE
OHP00448473OtherRAILROAD MEDICARE
OH0752261Medicaid
OH4224541Medicare PIN