MEDICARE: JAMES F ZUMSTEIN MD LLC

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	037931	GA
2	207Q00000X	Family Medicine Physician	00017633	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00009293	OTHER		PALMETTO MEDICARE RAILROA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51515341ZUM	OTHER	AL	BCBS
2	52580378-001	OTHER	GA	BCBS

General Provider Information

NPI Number	:	1013021021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES F ZUMSTEIN MD LLC

Provider Business Mailing Address
First Line	:	1810 STADIUM DRIVE
Second Line	:	SUITE 230
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3100
Country	:	US
Telephone Number	:	334-664-0219
Fax Number	:

Provider Business Practice Location Address
First Line	:	1810 STADIUM DRIVE
Second Line	:	SUITE 230
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-3100
Country	:	US
Telephone Number	:	334-664-0219
Fax Number	:	334-664-0224

Authorized Official
Title or Position	:	OFFICE MANANGER
Name	:	DORIS JEAN CANNON
Credential	:
Telephone Number	:	334-664-0219

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	08/22/2020

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Directions to “JAMES F ZUMSTEIN MD LLC ” Practice Location

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