Individual
EDWARD D ZDOBYLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1901 W 3RD, SUITEA, ELK CITY, OK 73644-7364
(580) 225-2513
(580) 303-5863
Mailing address
PO BOX 2339, ELK CITY, OK 73648-2339
(805) 225-2513
(580) 303-5863
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01051068A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000939921
ANTHEM LEGACY #
IN
05
—
200377800
—
IN
Enumeration date
07/25/2006
Last updated
05/03/2023
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