Provider Demographics
NPI:1245610872
Name:MASTERS, ZACHARY AUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:AUSTIN
Last Name:MASTERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 SOMDG
Mailing Address - Street 2:113 LIELMANIS AVE
Mailing Address - City:HURLBURT FIELD
Mailing Address - State:FL
Mailing Address - Zip Code:32544
Mailing Address - Country:US
Mailing Address - Phone:850-881-2129
Mailing Address - Fax:850-881-0481
Practice Address - Street 1:1 SOMDG
Practice Address - Street 2:113 LIELMANIS AVE
Practice Address - City:HURLBURT FIELD
Practice Address - State:FL
Practice Address - Zip Code:32544
Practice Address - Country:US
Practice Address - Phone:850-881-2129
Practice Address - Fax:850-881-0481
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE29456171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider