Provider Demographics
NPI:1942472964
Name:RICHARD C ZATCOFF DPM
Entity Type:Organization
Organization Name:RICHARD C ZATCOFF DPM
Other - Org Name:UPSTATE PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:P
Authorized Official - Last Name:FUGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-399-9070
Mailing Address - Street 1:114B HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3226
Mailing Address - Country:US
Mailing Address - Phone:864-399-9070
Mailing Address - Fax:864-399-9664
Practice Address - Street 1:114B HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3226
Practice Address - Country:US
Practice Address - Phone:864-399-9070
Practice Address - Fax:864-399-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC121213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U31804Medicare UPIN
U318045308Medicare PIN