Healthcare Provider Details

I. General information

NPI: 1588778591
Provider Name (Legal Business Name): JAMES FREDERICK ZUMSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 STADIUM DRIVE SUITE 230
PHENIX CITY AL
36867-3100
US

IV. Provider business mailing address

1810 STADIUM DRIVE SUITE 230
PHENIX CITY AL
36867-3100
US

V. Phone/Fax

Practice location:
  • Phone: 334-664-0219
  • Fax: 334-664-0224
Mailing address:
  • Phone: 334-664-0219
  • Fax: 334-664-0224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number00017633
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number037931
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: