Individual
DAVID J. ZOELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2413 RING RD STE 110, ELIZABETHTOWN, KY 42701-5924
(270) 765-4535
(270) 763-1901
Mailing address
2413 RING RD STE 110, ELIZABETHTOWN, KY 42701-5924
(270) 765-4535
(270) 763-1901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26429
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
26429
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050365
ANTHEM BCBS
KY
05
—
1510590
—
TN
05
—
4047817
—
TN
05
—
6426429400
—
KY
Enumeration date
11/28/2005
Last updated
12/10/2024
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