MEDICARE: JOSEPH SCOTT ZICKAFOOSE MD

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	208000000X	Pediatrics Physician	57009054	OH
2	208000000X	Pediatrics Physician	4301095310	MI
3	208000000X	Pediatrics Physician	35089753	OH
4	208000000X	Pediatrics Physician	MD53314	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	751032	OTHER	OH	BUCKEYE
2	415059	OTHER	OH	WELLCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000527973	OTHER	OH	ANTHEM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	9569067	OTHER	OH	AETNA
7	000000221308	OTHER	OH	UNISON

General Provider Information

NPI Number	:	1053524421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH SCOTT ZICKAFOOSE MD

Provider Business Mailing Address
First Line	:	1500 E MEDICAL CENTER DR
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-5000
Country	:	US
Telephone Number	:	734-647-5299
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 W MICHIGAN AVE
Second Line	:
City	:	YPSILANTI
State	:	MI
Zip	:	48197-5443
Country	:	US
Telephone Number	:	734-539-5080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	12/11/2025

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Directions to “ JOSEPH SCOTT ZICKAFOOSE MD” Practice Location

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