Provider Demographics
NPI:1962459214
Name:ZEAVIN, GERALD LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:LEE
Last Name:ZEAVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3630 SW FAIRLAWN RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-3966
Mailing Address - Country:US
Mailing Address - Phone:785-273-8080
Mailing Address - Fax:785-273-2583
Practice Address - Street 1:3630 SW FAIRLAWN RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-3966
Practice Address - Country:US
Practice Address - Phone:785-273-8080
Practice Address - Fax:785-273-2583
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0431843207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200376310AMedicaid
KS0431843OtherLICENSE
OK14372OtherLICENSE
OK14372OtherLICENSE
KSBZ1459482OtherDEA
KSC95725Medicare UPIN