Basic Information
| Provider Information | |||||||||
| NPI: | 1821254269 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ZWERNER | ||||||||
| FirstName: | FRANK | ||||||||
| MiddleName: | ANTON | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1606 N 7TH ST | ||||||||
| Address2: | |||||||||
| City: | TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478042780 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8122387000 | ||||||||
| FaxNumber: | 8122424590 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 S MURPHY AVENUE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | BRAZIL | ||||||||
| State: | IN | ||||||||
| PostalCode: | 478348296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8124422100 | ||||||||
| FaxNumber: | 8124464409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2008 | ||||||||
| LastUpdateDate: | 09/24/2018 | ||||||||
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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 | 207Q00000X | 02003595A | IN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000721787 | 01 | IN | ANTHEM | OTHER | 200975210 | 05 | IN | MEDICAID |