Provider Demographics
NPI:1174586143
Name:OVERBECK-ZISKO, TERRI LYNN (MD)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:LYNN
Last Name:OVERBECK-ZISKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERRI
Other - Middle Name:LYNN
Other - Last Name:ZISKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3260 WESTBOURNE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-5107
Mailing Address - Country:US
Mailing Address - Phone:513-674-1400
Mailing Address - Fax:513-206-1904
Practice Address - Street 1:3260 WESTBOURNE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-5107
Practice Address - Country:US
Practice Address - Phone:513-674-1400
Practice Address - Fax:513-206-1904
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070137207RH0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0380878Medicaid
OHF86426Medicare UPIN
OH0380878Medicaid