MEDICARE: V.GEORGE ZOCHOWSKI, D.O.,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	34002145	OH

General Provider Information

NPI Number	:	1003912403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V.GEORGE ZOCHOWSKI, D.O.,INC.

Provider Business Mailing Address
First Line	:	8200 HAZELTON ETNA RD SW
Second Line	:	SUITE 100
City	:	PATASKALA
State	:	OH
Zip	:	43062-9630
Country	:	US
Telephone Number	:	740-927-7665
Fax Number	:	740-964-0342

Provider Business Practice Location Address
First Line	:	8200 HAZELTON ETNA RD SW
Second Line	:	SUITE 100
City	:	PATASKALA
State	:	OH
Zip	:	43062-9630
Country	:	US
Telephone Number	:	740-927-7665
Fax Number	:	740-964-0342

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. VITOLD GEORGE ZOCHOWSKI
Credential	:	D.O.
Telephone Number	:	740-927-7665

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	08/22/2020

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