Healthcare Provider Details

I. General information

NPI: 1407815343
Provider Name (Legal Business Name): TODD E ZEIGLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 01/11/2021
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 W 78TH ST
EDINA MN
55439-2516
US

IV. Provider business mailing address

PO BOX 1189
CORVALLIS OR
97339-1189
US

V. Phone/Fax

Practice location:
  • Phone: 952-946-9777
  • Fax: 952-946-9888
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberM-12226
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD60912644
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number61804
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: