MEDICARE: DR. BRIAN JOSEPH ZAGAR D.P.M.

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	213E00000X	Podiatrist	229	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	1303190001	OTHER		DMERK MEDICARE
7	480029634	OTHER		MEDICARE RAIL ROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	631229547	OTHER		TAX ID#
2	44621	OTHER	AL	OATH
4	58737	OTHER	AL	BLUE CROSS BLUE SHIELD
5	5480467	OTHER		AETNA
6	631229547	OTHER		TRICARE
8	1303190001	OTHER		PALMETTO GBA
9	27-10155	OTHER	AL	UNITED HEALTH CARE
10	510	OTHER	AL	PLAN CODE BLUE CROSS BLUE

General Provider Information

NPI Number	:	1811910151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN JOSEPH ZAGAR D.P.M.

Provider Business Mailing Address
First Line	:	546 MCQUEEN SMITH RD N
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36066-5558
Country	:	US
Telephone Number	:	334-358-9765
Fax Number	:	334-358-5434

Provider Business Practice Location Address
First Line	:	546 MCQUEEN SMITH RD N
Second Line	:
City	:	PRATTVILLE
State	:	AL
Zip	:	36066-5558
Country	:	US
Telephone Number	:	334-358-9765
Fax Number	:	334-358-5434

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	12/03/2010

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Directions to “ DR. BRIAN JOSEPH ZAGAR D.P.M.” Practice Location

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