Provider Demographics
NPI:1801840202
Name:ZITTERMAN, JOSEPH A JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:ZITTERMAN
Suffix:JR
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 1:306 TURRENTINE WAY
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-8879
Mailing Address - Country:US
Mailing Address - Phone:479-223-3333
Mailing Address - Fax:
Practice Address - Street 1:306 TURRENTINE WAY
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AR
Practice Address - Zip Code:72802-8879
Practice Address - Country:US
Practice Address - Phone:479-223-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041834207R00000X, 208M00000X
ARM7888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0194984OtherDEPT OF LABOR & INDUSTRY
WA8359994Medicaid
WA0194984OtherDEPT OF LABOR & INDUSTRY
G27765Medicare UPIN