MEDICARE: DR. JILL MARIE ZINNER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	41000	KY
2	2084P0800X	Psychiatry Physician	01075367A	IN

General Provider Information

NPI Number	:	1932235363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL MARIE ZINNER MD

Provider Business Mailing Address
First Line	:	1229 RUFER AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1627
Country	:	US
Telephone Number	:	502-727-4233
Fax Number	:	502-290-0661

Provider Business Practice Location Address
First Line	:	1402 BROWNS LN
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4609
Country	:	US
Telephone Number	:	502-894-0234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	05/18/2015

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