Provider Demographics
NPI:1891096236
Name:ZWOUND CARE
Entity Type:Organization
Organization Name:ZWOUND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:601-250-0162
Mailing Address - Street 1:1126 COUNTRY CLUB ROAD
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39648
Mailing Address - Country:US
Mailing Address - Phone:601-250-0139
Mailing Address - Fax:601-250-0139
Practice Address - Street 1:1126 COUNTRY CLUB ROAD
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648
Practice Address - Country:US
Practice Address - Phone:601-250-0162
Practice Address - Fax:601-250-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty