Healthcare Provider Details

I. General information

NPI: 1942472964
Provider Name (Legal Business Name): RICHARD C ZATCOFF DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 10/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114B HOSPITAL DR
SIMPSONVILLE SC
29681-3226
US

IV. Provider business mailing address

114B HOSPITAL DR
SIMPSONVILLE SC
29681-3226
US

V. Phone/Fax

Practice location:
  • Phone: 864-399-9070
  • Fax: 864-399-9664
Mailing address:
  • Phone: 864-399-9070
  • Fax: 864-399-9664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number121
License Number StateSC

VIII. Authorized Official

Name: REBECCA P FUGEL
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 864-399-9070