| Organization Name: | PHILIP ZUMWALT,M.D. |
| NPI Number: | 1508946112 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILIP FRANK ZUMWALT (OWNER/PHYSICIAN) |
| Mailing Address: | 125 S 4th St Watseka |
| State: | IL US |
| Postal Code: | 609701601 |
| Phone Number: | 8154325430 |
| Fax Number: | 8154326024 |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 10/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |