Individual
DR. MARK M ZIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
216 2ND ST NE, INDEPENDENCE, IA 50644-1910
(319) 334-3631
(319) 334-3631
Mailing address
216 2ND ST NE, INDEPENDENCE, IA 50644-1910
(319) 334-3631
(319) 334-3631
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1967
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0419424
—
IA
05
—
0419432
—
IA
01
—
06297
BLUE CROSS & BLUE SHIELD
IA
01
—
08106
BCBS FOR OELWEIN
IA
01
—
43738
BCBS
IA
01
—
P00000678
RAILROAD MEDICARE
IA
Enumeration date
06/24/2005
Last updated
01/23/2008
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