Provider Demographics
NPI:1508849225
Name:ZANGA, JOSEPH ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ROBERT
Last Name:ZANGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1038
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902
Mailing Address - Country:US
Mailing Address - Phone:706-571-1221
Mailing Address - Fax:706-571-1070
Practice Address - Street 1:710 CENTER STREET, BOX 7B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31902
Practice Address - Country:US
Practice Address - Phone:706-571-1221
Practice Address - Fax:706-571-1070
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201212208000000X
GA062014208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89132U4Medicaid
GA857459595AMedicaid
NC132U4OtherBCBS NC
NC370021876OtherRAILROAD MEDICARE
NC370021876OtherRAILROAD MEDICARE
GA857459595AMedicaid
NCB09843Medicare UPIN