Healthcare Provider Details

I. General information

NPI: 1679542179
Provider Name (Legal Business Name): HARRY ZIBNERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 08/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 RIVER VALLEY BLVD
LANCASTER OH
43130-1653
US

IV. Provider business mailing address

PO BOX 1523
LIMA OH
45802-1523
US

V. Phone/Fax

Practice location:
  • Phone: 740-654-6312
  • Fax:
Mailing address:
  • Phone: 419-224-5707
  • Fax: 419-229-0040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35.030200
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC30451
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: