Healthcare Provider Details

I. General information

NPI: 1487656682
Provider Name (Legal Business Name): JENNIFER KATHERINE ZOCHOWSKI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 HAZELTON ETNA RD SW STE 100
PATASKALA OH
43062-9630
US

IV. Provider business mailing address

8200 HAZELTON ETNA RD SW STE 100
PATASKALA OH
43062-9630
US

V. Phone/Fax

Practice location:
  • Phone: 740-927-7665
  • Fax: 740-964-0342
Mailing address:
  • Phone: 740-927-7665
  • Fax: 740-964-0342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35077242
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: