Provider Demographics
NPI:1528006525
Name:ZARGE, JOSEPH I (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:I
Last Name:ZARGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSEPH
Other - Middle Name:ISAAC
Other - Last Name:ZARGE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1838 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-6611
Mailing Address - Country:US
Mailing Address - Phone:770-995-7622
Mailing Address - Fax:770-995-7854
Practice Address - Street 1:5673 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:STE 675
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1731
Practice Address - Country:US
Practice Address - Phone:678-843-5400
Practice Address - Fax:678-843-5449
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0441502086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003118922GMedicaid
GA003118922HMedicaid
GA003118922KMedicaid
GA770001464OtherRR
GA003118922DMedicaid
GA003118922FMedicaid
GA003118922IMedicaid
GA003118922JMedicaid
GA03118922CMedicaid
GA003118922BMedicaid
GA003118922AMedicaid
GA00758733AMedicaid
GA003118922EMedicaid
GA202I770566Medicare PIN
F86628Medicare UPIN
GA03118922CMedicaid