Provider Demographics
NPI:1902844178
Name:ZONIA, CAROLYNN L (DO)
Entity Type:Individual
Prefix:
First Name:CAROLYNN
Middle Name:L
Last Name:ZONIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 BISHOP ST STE 1904
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4102
Mailing Address - Country:US
Mailing Address - Phone:808-369-0179
Mailing Address - Fax:
Practice Address - Street 1:BAYNE JONES ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:1585 THIRD ST
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-4815
Practice Address - Country:US
Practice Address - Phone:337-531-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13889207P00000X
MI5101010804207P00000X
IL036-086002207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036086002Medicaid
IL930062809OtherMEDICARE RAILROAD
ILL64086Medicare ID - Type Unspecified
IL036086002Medicaid