Provider Demographics
NPI:1417614306
Name:ZAMPOGNA, GIULIO (PA-C)
Entity Type:Individual
Prefix:
First Name:GIULIO
Middle Name:
Last Name:ZAMPOGNA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 PINE COVE CIR
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71446-9091
Mailing Address - Country:US
Mailing Address - Phone:607-423-6359
Mailing Address - Fax:
Practice Address - Street 1:BAYNE-JONES ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:1585 THIRD ST.
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459
Practice Address - Country:US
Practice Address - Phone:337-531-3011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-26
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program