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Organization
CHARLES J ZIMMERMANN DPM
Active
Organization
CHARLES J ZIMMERMANN DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES JOHN ZIMMERMANN DPM (PHYSICIAN)
(859) 236-5140
Entity
Organization
Contact information
Practice address
105 CITATION DR, SUITE D, DANVILLE, KY 40422-8633
(859) 236-5140
(859) 236-5153
Mailing address
105 CITATION DR, SUITE D, DANVILLE, KY 40422-8633
(859) 236-5140
(859) 236-5153
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
KY206
KY
332B00000X
Durable Medical Equipment & Medical Supplies
00206
KY
332BC3200X
Customized Equipment (DME)
00206
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000066482
ANTHEM
KY
05
—
80002066
—
KY
Enumeration date
04/16/2007
Last updated
11/05/2008
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