Provider Demographics
NPI:1568487569
Name:DEATON, ZACHARY N (RD,LDN)
Entity Type:Individual
Prefix:MR
First Name:ZACHARY
Middle Name:N
Last Name:DEATON
Suffix:
Gender:M
Credentials:RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 S 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-3437
Mailing Address - Country:US
Mailing Address - Phone:919-663-3923
Mailing Address - Fax:
Practice Address - Street 1:1000 S 10TH AVE
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-3324
Practice Address - Country:US
Practice Address - Phone:919-742-5641
Practice Address - Fax:919-742-7496
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL002836133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCL002836OtherLDN LICENSE
NCL002836OtherLDN LICENSE