Provider Demographics
NPI:1356304133
Name:ZIOBROWSKI, THOMAS FRANK (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANK
Last Name:ZIOBROWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 BREEZY HILL RD
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-8882
Mailing Address - Country:US
Mailing Address - Phone:802-748-7500
Mailing Address - Fax:802-745-1188
Practice Address - Street 1:714 BREEZY HILL RD
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-8882
Practice Address - Country:US
Practice Address - Phone:802-748-7500
Practice Address - Fax:802-745-1188
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420006256207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0004329Medicaid
VTB85417OtherMEDICARE UPIN NUMBER
VTVT4329Medicare ID - Type UnspecifiedMEDICARE