MEDICARE: JOSHUA THOMAS ZIEBELL OD

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	152W00000X	Optometrist	1884	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410007312	OTHER	NC	MEDICARE - GEORGIA
6	804273	OTHER	NC	PARTNERS MEDICARE CHOICE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	30632	OTHER	NC	OPTICARE
3	2399655	OTHER	NC	UNITED HEALTHCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	093PG	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1558305276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA THOMAS ZIEBELL OD

Provider Business Mailing Address
First Line	:	820 LOWER DALLAS HWY
Second Line	:
City	:	DALLAS
State	:	NC
Zip	:	28034-9368
Country	:	US
Telephone Number	:	704-922-9808
Fax Number	:	704-853-8029

Provider Business Practice Location Address
First Line	:	820 LOWER DALLAS HWY
Second Line	:
City	:	DALLAS
State	:	NC
Zip	:	28034-9368
Country	:	US
Telephone Number	:	704-922-9808
Fax Number	:	704-853-8029

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	06/17/2011

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Directions to “ JOSHUA THOMAS ZIEBELL OD” Practice Location

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