Healthcare Provider Details

I. General information

NPI: 1790973915
Provider Name (Legal Business Name): JOSEPH CHARLES ZOLA JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 09/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 PROFESSIONAL PARK SUITE C
OXFORD NC
27565-2501
US

IV. Provider business mailing address

102 PROFESSIONAL PARK SUITE C
OXFORD NC
27565-2501
US

V. Phone/Fax

Practice location:
  • Phone: 919-690-0435
  • Fax: 919-690-3430
Mailing address:
  • Phone: 919-690-0435
  • Fax: 919-690-3430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number2012-01187
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMT188449
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: