Provider Demographics
NPI:1295767077
Name:ZARA, JOSHUA (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:ZARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSH
Other - Middle Name:
Other - Last Name:ZARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:801 SAINT MARYS DR STE 205W
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0556
Mailing Address - Country:US
Mailing Address - Phone:812-477-6103
Mailing Address - Fax:812-477-4897
Practice Address - Street 1:801 SAINT MARYS DR STE 205W
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714
Practice Address - Country:US
Practice Address - Phone:812-477-6103
Practice Address - Fax:812-477-4897
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01079661A207RG0100X
GA36912207RG0100X
OH35.095854207RG0100X
AZ28666207RG0100X
TXJ1820207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129893706Medicaid
TX8F0715OtherBCBS
OHP01660042OtherRAILROAD MEDICARE - MHCPI
OH0141842Medicaid
WV3810029688Medicaid
AZ294218Medicaid
AZ1288142OtherCIGNA
AZ4331326OtherAETNA
TX8G7887Medicare PIN
AZNPI #1295767077Medicare PIN
WV3810029688Medicaid
OHH411581Medicare PIN
OHH411580Medicare PIN
OH0141842Medicaid