Provider Demographics
NPI:1326785684
Name:ADAMS, ZACHARY EATON (PA-S)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:EATON
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:AZ
Mailing Address - Zip Code:86329-0206
Mailing Address - Country:US
Mailing Address - Phone:928-830-2801
Mailing Address - Fax:
Practice Address - Street 1:2500 S STATE ROUTE 69
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:AZ
Practice Address - Zip Code:86329-0148
Practice Address - Country:US
Practice Address - Phone:928-830-2801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program