Provider Demographics
NPI:1205808979
Name:ZOELLE, JEFFREY T (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:T
Last Name:ZOELLE
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 1:532 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:BRITT
Mailing Address - State:IA
Mailing Address - Zip Code:50423-1227
Mailing Address - Country:US
Mailing Address - Phone:641-843-5050
Mailing Address - Fax:641-843-5051
Practice Address - Street 1:532 1ST ST NW
Practice Address - Street 2:
Practice Address - City:BRITT
Practice Address - State:IA
Practice Address - Zip Code:50423-1227
Practice Address - Country:US
Practice Address - Phone:641-843-5050
Practice Address - Fax:641-843-5051
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33008207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080192682OtherMEDICARE RAILROAD
NE42105918214Medicaid
IA3195982Medicaid
IA30354OtherWELLMARK BCBS OF IOWA
IA1205808979Medicaid
SD7704900Medicaid
NE277606OtherMEDICARE
IA1205808979Medicaid
H10572Medicare UPIN