Basic Information
| Provider Information | |||||||||
| NPI: | 1528006525 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZARGE | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | I | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ZARGE | ||||||||
| OtherFirstName: | JOSEPH | ||||||||
| OtherMiddleName: | ISAAC | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1838 AMERICAN WAY | ||||||||
| Address2: | |||||||||
| City: | LAWRENCEVILLE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300436611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709957622 | ||||||||
| FaxNumber: | 7709957854 | ||||||||
| Practice Location | |||||||||
| Address1: | 5673 PEACHTREE DUNWOODY RD NE | ||||||||
| Address2: | STE 675 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421731 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788435400 | ||||||||
| FaxNumber: | 6788435449 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 04/01/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | 044150 | GA | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 003118922G | 05 | GA | MEDICAID | 003118922H | 05 | GA | MEDICAID | 003118922K | 05 | GA | MEDICAID | 770001464 | 01 | GA | RR | OTHER | 003118922D | 05 | GA | MEDICAID | 003118922F | 05 | GA | MEDICAID | 003118922I | 05 | GA | MEDICAID | 003118922J | 05 | GA | MEDICAID | 03118922C | 05 | GA | MEDICAID | 003118922B | 05 | GA | MEDICAID | 003118922A | 05 | GA | MEDICAID | 00758733A | 05 | GA | MEDICAID | 003118922E | 05 | GA | MEDICAID |