Provider Demographics
NPI:1245507250
Name:THOMAS L. ZOELLER, MD,PA
Entity type:Organization
Organization Name:THOMAS L. ZOELLER, MD,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZOELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-629-0028
Mailing Address - Street 1:2760 SE 17TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5550
Mailing Address - Country:US
Mailing Address - Phone:352-629-0028
Mailing Address - Fax:352-629-1512
Practice Address - Street 1:2760 SE 17TH ST STE 102
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5550
Practice Address - Country:US
Practice Address - Phone:352-629-0028
Practice Address - Fax:352-629-1512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58310Medicare UPIN