Individual
DR. MARSHALL W ZAMORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
210 W MAIN CROSS ST, EDINBURGH, IN 46124-1390
(812) 526-2020
Mailing address
PO BOX 576, VERNON, IN 47282-0576
(812) 521-2002
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
P00107057
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000308885
ANTHEM
IN
05
—
200453530
—
IN
Enumeration date
06/02/2005
Last updated
06/20/2012
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