Provider Demographics
NPI:1528063740
Name:ZISKO, JOHN PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:ZISKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4440 GLEN ESTE WITHAMSVILLE RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1318
Mailing Address - Country:US
Mailing Address - Phone:513-753-7488
Mailing Address - Fax:513-753-7879
Practice Address - Street 1:4440 GLEN ESTE WITHAMSVILLE RD
Practice Address - Street 2:SUITE 500
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1318
Practice Address - Country:US
Practice Address - Phone:513-753-7488
Practice Address - Fax:513-753-7879
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-07-0596-Z207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0114638OtherUNITED HEALTHCARE
OH000000382636OtherANTHEM
OH0307420Medicaid
OHP00313803OtherMEDICARE RAILROAD
OH8246385OtherCIGNA
OH0225920002Medicare NSC
OH8246385OtherCIGNA
OHF84944Medicare UPIN