Individual
KEVIN A ZACOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
267 CENTER ST, SEVILLE, OH 44273-8864
(330) 769-2941
(330) 769-4804
Mailing address
267 CENTER ST, SEVILLE, OH 44273-8864
(330) 769-2941
(330) 769-4804
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.003531
OH
207Q00000X
Family Medicine Physician
OS005098L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017204180007
—
PA
01
—
024351
MEDICARE ID
PA
05
—
0525462
—
OH
01
—
4112483
MEDICARE ID
OH
Enumeration date
02/23/2006
Last updated
11/15/2011
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