Provider Demographics
NPI:1912909268
Name:ZOCHOWSKI, VITOLD GEORGE (DO)
Entity Type:Individual
Prefix:DR
First Name:VITOLD
Middle Name:GEORGE
Last Name:ZOCHOWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8200 HAZELTON ETNA RD SW
Practice Address - Street 2:STE 100
Practice Address - City:ETNA
Practice Address - State:OH
Practice Address - Zip Code:43062-9630
Practice Address - Country:US
Practice Address - Phone:740-927-7665
Practice Address - Fax:740-964-0342
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34002145Z207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0214235Medicaid
OH0214235Medicaid
OHE00587Medicare UPIN