Provider Demographics
NPI:1679542179
Name:ZIBNERS, HARRY (MD)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:ZIBNERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1523
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45802-1523
Mailing Address - Country:US
Mailing Address - Phone:419-224-5707
Mailing Address - Fax:419-229-0040
Practice Address - Street 1:1241 RIVER VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1653
Practice Address - Country:US
Practice Address - Phone:740-654-6312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0302002085R0202X
CAC304512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C304510Medicaid
OH2334021Medicaid
CAP00342915Medicare PIN
CA00C304515Medicare PIN
CA00C304510Medicaid
CA00C304514Medicare PIN
CA00C304516Medicare PIN
CA00C304512Medicare PIN
A34264Medicare UPIN
OHZI4088192Medicare PIN
CA00C304517Medicare PIN
CA00C304510Medicare PIN
OH2334021Medicaid
CA00C304513Medicare PIN