Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP0504X | Public Medicine | 295 | AL |
Y | 213EP1101X | Primary Podiatric Medicine | 295 | AL |
N | 111NR0200X | Radiology | 295 | AL |
N | 213ER0200X | Radiology | 295 | AL |
N | 2081S0010X | Sports Medicine | 295 | AL |
N | 213ES0000X | Sports Medicine | 295 | AL |
N | 213ES0103X | Foot & Ankle Surgery | 295 | AL |
N | 213ES0131X | Foot Surgery | 295 | AL |
NPI | 1013179621 |
---|---|
Provider Name | Dr. Travis Jason Zimbelman |
First Address | Prattville, AL 36066-7554 |
Second Address | Montgomery, AL 36117-3558 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 02/07/2019 |