Individual
JACK RZEPKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4200 WARRENSVILLE CENTER RD, SUITE 420, BEACHWOOD, OH 44122-7051
(216) 752-9055
(216) 752-0990
Mailing address
4200 WARRENSVILLE CENTER RD, SUITE 420, BEACHWOOD, OH 44122-7051
(216) 752-9055
(216) 752-0990
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-05-1524-R
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000503638
ANTHEM BLUE SHIELD
OH
01
—
000000536387
ANTHEM BLUE SHIELD
OH
05
—
0731864
—
OH
01
—
2350992
CIGNA
OH
Enumeration date
08/31/2005
Last updated
02/28/2008
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