Individual
THOMAS ROBERT ZACHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
7625 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 432-1231
Mailing address
7625 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4133
(260) 432-1231
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001698A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100080310B
—
IN
Enumeration date
07/12/2006
Last updated
01/20/2011
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