Healthcare Provider Details

I. General information

NPI: 1568994085
Provider Name (Legal Business Name): ZACHARY EYRE M.D., MBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 HOWELL MILL RD NW STE 211
ATLANTA GA
30327-4100
US

IV. Provider business mailing address

3280 HOWELL MILL RD NW STE 211
ATLANTA GA
30327-4100
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-7546
  • Fax: 404-351-2993
Mailing address:
  • Phone: 404-351-7546
  • Fax: 404-351-2993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number89990
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: