Provider Demographics
NPI:1619935269
Name:ZIRKEL, THOMAS E (DPM)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:ZIRKEL
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 1:1626 TUTTLE ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-1501
Mailing Address - Country:US
Mailing Address - Phone:608-355-2033
Mailing Address - Fax:608-355-6820
Practice Address - Street 1:1626 TUTTLE ST
Practice Address - Street 2:
Practice Address - City:BARABOO
Practice Address - State:WI
Practice Address - Zip Code:53913-1501
Practice Address - Country:US
Practice Address - Phone:608-355-2033
Practice Address - Fax:608-355-6820
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI836-025213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1619935269Medicaid
WIP01428793Medicare PIN
WIK400176793Medicare PIN
WI1041806OtherPHYSICIANS PLUS
WI004813215Medicare PIN
WI05257155Medicare PIN
WI480034623Medicare PIN