Organization
DR. MARK M. ZIMMER P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK MATTHEW ZIMMER OD (PRESIDENT)
(319) 334-3631
Entity
Organization
Contact information
Practice address
216 2ND ST NE, INDEPENDENCE, IA 50644-1910
(319) 334-3631
Mailing address
216 2ND ST NE, INDEPENDENCE, IA 50644-1910
(319) 334-3631
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01967
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0419424
—
IA
05
—
5078170
—
IA
01
—
BCBS OF IOWA
06297
IA
Enumeration date
11/24/2006
Last updated
01/22/2008
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