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NPI Code Detail

MEDICARE: ZDENEK A TUSEK M.D.

MEDICARE: ZDENEK A TUSEK M.D.
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
12085R0202XDiagnostic Radiology Physician3694AWY
2208D00000XGeneral Practice Physician16941NE

General Provider Information

NPI Number : 1073602116
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZDENEK A TUSEK M.D.
Provider Business Mailing Address
First Line : 359 STETLER AVE
Second Line :
City : SELINSGROVE
State : PA
Zip : 17870-9031
Country : US
Telephone Number : 570-743-8657
Fax Number :
Provider Business Practice Location Address
First Line : 4055 VALLEY VIEW LN
Second Line :
City : DALLAS
State : TX
Zip : 75244-5074
Country : US
Telephone Number : 972-715-3800
Fax Number : 888-705-9777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 02/02/2017

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