Healthcare Provider Details

I. General information

NPI: 1619935269
Provider Name (Legal Business Name): THOMAS E ZIRKEL DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 12/23/2020
Certification Date: 12/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 TUTTLE ST
BARABOO WI
53913-1501
US

IV. Provider business mailing address

1626 TUTTLE ST
BARABOO WI
53913-1501
US

V. Phone/Fax

Practice location:
  • Phone: 608-355-2033
  • Fax: 608-355-6820
Mailing address:
  • Phone: 608-355-2033
  • Fax: 608-355-6820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number836-025
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: