MEDICARE: JACOB WALTER ZIMMER MSW,LSW

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	104100000X	Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437380565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB WALTER ZIMMER MSW,LSW

Provider Business Mailing Address
First Line	:	3325 GLENMORE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-6510
Country	:	US
Telephone Number	:	513-233-4852
Fax Number	:	513-471-4732

Provider Business Practice Location Address
First Line	:	3325 GLENMORE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211
Country	:	US
Telephone Number	:	513-233-4852
Fax Number	:	513-471-4732

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

Provider Enumeration Date	:	08/06/2009
Last Update Date	:	04/29/2019

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