Provider Demographics
NPI:1548339120
Name:ZANESVILLE FAMILY PRACTICE INC
Entity type:Organization
Organization Name:ZANESVILLE FAMILY PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:KRISTOFER
Authorized Official - Middle Name:GIBSON
Authorized Official - Last Name:SANDLUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-452-7359
Mailing Address - Street 1:1215 NEWARK ROAD
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2816
Mailing Address - Country:US
Mailing Address - Phone:740-452-7359
Mailing Address - Fax:740-452-7309
Practice Address - Street 1:1215 NEWARK ROAD
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2816
Practice Address - Country:US
Practice Address - Phone:740-452-7359
Practice Address - Fax:740-452-7309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty