Provider Demographics
NPI:1992069769
Name:ZEIGLER, ALYSIA MARIA (DO)
Entity type:Individual
Prefix:
First Name:ALYSIA
Middle Name:MARIA
Last Name:ZEIGLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 STATE ST
Mailing Address - Street 2:STE B
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1981
Mailing Address - Country:US
Mailing Address - Phone:330-729-1950
Mailing Address - Fax:330-729-1951
Practice Address - Street 1:53 STATE ST
Practice Address - Street 2:STE B
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1981
Practice Address - Country:US
Practice Address - Phone:330-729-1950
Practice Address - Fax:330-729-1951
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT014863207Q00000X
OH34.011753207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01037267Medicaid
OHH373520Medicare UPIN