Individual
TIMOTHY R ZEIDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
975 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(414) 852-8043
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5639
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100194132
—
WI
Enumeration date
06/01/2021
Last updated
02/19/2025
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