NPI Code Detail JSON Logo

1508489246 NPI number — ZACKERY ERIC ASBURY MD

NPI Number: 1508489246
Health Care Provider/Practitioner: ZACKERY ERIC ASBURY MD

Information about “1508489246” NPI (ZACKERY ERIC ASBURY MD) exists in 1508489246 in HTML format HTML  |  1508489246 in plain Text format TXT  |  1508489246 in PDF (Portable Document Format) PDF  |  1508489246 in an XML format XML  formats.

NPI Number : 1508489246 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508489246",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ASBURY",
    "FirstName": "ZACKERY",
    "MiddleName": "ERIC",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 114",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DAVIN",
    "MailingAddressStateName": "WV",
    "MailingAddressPostalCode": "25617-0114",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "304-942-7633",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "600 E MCDONALD AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MAN",
    "PracticeLocationAddressStateName": "WV",
    "PracticeLocationAddressPostalCode": "25635-1023",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "304-583-8585",
    "PracticeLocationAddressFaxNumber": "304-583-0129",
    "EnumerationDate": "05/28/2020",
    "LastUpdateDate": "08/12/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "31508",
        "LicenseNumberStateCode": "WV",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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