Healthcare Provider Details

I. General information

NPI: 1356390140
Provider Name (Legal Business Name): JOHN G ZOGRAFAKIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 04/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ARCH ST SUITE 240
AKRON OH
44304-1437
US

IV. Provider business mailing address

95 ARCH ST SUITE 255
AKRON OH
44304-1437
US

V. Phone/Fax

Practice location:
  • Phone: 330-761-9930
  • Fax: 330-761-9936
Mailing address:
  • Phone: 330-761-9930
  • Fax: 330-761-9936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35-079434
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: