Healthcare Provider Details

I. General information

NPI: 1427582923
Provider Name (Legal Business Name): THOMAS ALAN ZUMBAUGH DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8325 S EMERSON AVE STE B1
INDIANAPOLIS IN
46237-8559
US

IV. Provider business mailing address

8325 S EMERSON AVE STE B1
INDIANAPOLIS IN
46237-8559
US

V. Phone/Fax

Practice location:
  • Phone: 317-742-6575
  • Fax:
Mailing address:
  • Phone: 317-742-6575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number07001409A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: