Provider Demographics
NPI:1376517144
Name:ZAKERS, GREGORY O (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:O
Last Name:ZAKERS
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 1:3634 CARRICK CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-8640
Mailing Address - Country:US
Mailing Address - Phone:770-732-6007
Mailing Address - Fax:770-732-8242
Practice Address - Street 1:5910 HILLANDALE DR
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-1884
Practice Address - Country:US
Practice Address - Phone:404-501-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049847207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA155520618BMedicaid
08BBWXFMedicare ID - Type Unspecified
GA155520618BMedicaid