MEDICARE: TERRI LYNN ZACCO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	9600790	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558366138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI LYNN ZACCO D.O.

Provider Business Mailing Address
First Line	:	3186 VILLAGE DR 201
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3979
Country	:	US
Telephone Number	:	910-486-5700
Fax Number	:	910-486-5950

Provider Business Practice Location Address
First Line	:	169 RAWLS RD
Second Line	:
City	:	ANGIER
State	:	NC
Zip	:	27501-8539
Country	:	US
Telephone Number	:	919-331-2001
Fax Number	:	919-331-2003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	07/01/2025

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