Healthcare Provider Details

I. General information

NPI: 1457333957
Provider Name (Legal Business Name): THOMAS A. ZIMMERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 S. 6TH ST.
NEVADA IA
50201-2534
US

IV. Provider business mailing address

230 S. 6TH ST.
NEVADA IA
50201-2534
US

V. Phone/Fax

Practice location:
  • Phone: 515-382-5471
  • Fax: 515-382-5621
Mailing address:
  • Phone: 515-382-5471
  • Fax: 515-382-5621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24084
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: