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General NPI Number Information
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NPI Number | 1386646669
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Entity Type | Individual
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Provider Name | EDWARD D ZIMMERMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 316 N 10TH ST
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City | WORLAND
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State | WY
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Zip | 82401-2307
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Country | US
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Telephone | 307-347-8885
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Fax | 307-347-2428
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Provider Business Mailing Address
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Address Line | 316 N 10TH ST
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City | WORLAND
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State | WY
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Zip | 82401-2307
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Country | US
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Telephone | 307-347-8885
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Fax | 307-347-2428
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 8034A
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 8034A
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 8034A
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License Number State | WY
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