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General NPI Number Information
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NPI Number | 1528063740
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Entity Type | Individual
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Provider Name | JOHN PATRICK ZISKO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 09/30/2013
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Provider Practice Location Address
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Address Line | 4440 GLEN ESTE WITHAMSVILLE RD SUITE 500
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City | CINCINNATI
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State | OH
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Zip | 45245-1318
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Country | US
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Telephone | 513-753-7488
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Fax | 513-753-7879
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Provider Business Mailing Address
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Address Line | 4440 GLEN ESTE WITHAMSVILLE RD SUITE 500
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City | CINCINNATI
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State | OH
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Zip | 45245-1318
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Country | US
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Telephone | 513-753-7488
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Fax | 513-753-7879
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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 | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 35-07-0596-Z
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License Number State | OH
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