=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841273802
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DALE T ZORN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/23/2005
-----------------------------------------------------
Last Update Date | 04/19/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8333 N DAVIS HWY
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32514-6050
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-474-8300
-----------------------------------------------------
Fax | 850-474-8654
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8333 N DAVIS HWY WEST FLORIDA MEDICAL CENTER ORTHOPAEDIC SURGERY
-----------------------------------------------------
City | PENSACOLA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32514-6050
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-474-8100
-----------------------------------------------------
Fax | 850-474-8083
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | ME0020224
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------