Provider Demographics
NPI:1669465316
Name:ZIEGLER, JOHN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:ZIEGLER
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:PO BOX 654
Mailing Address - Street 2:
Mailing Address - City:MER ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:71261-0654
Mailing Address - Country:US
Mailing Address - Phone:318-281-8596
Mailing Address - Fax:318-281-8099
Practice Address - Street 1:510S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-5033
Practice Address - Country:US
Practice Address - Phone:318-281-8596
Practice Address - Fax:318-281-8099
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-29
Last Update Date:2015-08-28
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
LA012780207V00000X
LAMD012780207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT17447OtherBLUE CROSS
AL1180955Medicaid
UT17447OtherBLUE CROSS
LAB60515Medicare UPIN