Provider Demographics
NPI:1871689521
Name:ZOUMIS, JOHN J (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:ZOUMIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 MILLENNIUM BLVD
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9173
Mailing Address - Country:US
Mailing Address - Phone:330-755-2987
Mailing Address - Fax:
Practice Address - Street 1:504 CYNTHIA DRIVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:OH
Practice Address - Zip Code:44440
Practice Address - Country:US
Practice Address - Phone:330-755-2987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001583152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist