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General NPI Number Information
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NPI Number | 1952850315
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Entity Type | Organization
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Legal Business Name | THOMAS P FORRESTAL JR
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Dates
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Enumeration Date | 09/27/2016
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 1115 STONINGTON PL
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City | ZANESVILLE
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State | OH
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Zip | 43701-7210
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Country | US
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Telephone | 740-607-7229
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Fax | 740-297-4963
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Provider Business Mailing Address
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Address Line | PO BOX 462
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City | DUNCAN FALLS
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State | OH
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Zip | 43734-0462
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Country | US
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Telephone | 740-319-1335
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Fax | 740-297-4963
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS P FORRESTAL JR.
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Credential | M.D.
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Telephone | 740-607-7229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 049982
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License Number State | OH
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