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General NPI Number Information
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NPI Number | 1114410040
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Entity Type | Individual
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Provider Name | ZACKARY ELKINS OD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 101 FLY CREEK AVE
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City | FAIRHOPE
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State | AL
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Zip | 36532-8305
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Country | US
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Telephone | 205-901-4721
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Fax | 251-383-2062
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Provider Business Mailing Address
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Address Line | PO BOX 207243
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City | DALLAS
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State | TX
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Zip | 75320-7243
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Country | US
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Telephone | 636-200-4393
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Fax | 636-527-0766
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S-E07-TA-B37
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License Number State | AL
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