Provider Demographics
NPI:1639732480
Name:JONES, ZACKARY
Entity Type:Individual
Prefix:MR
First Name:ZACKARY
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 ROPER MOUNTAIN RD STE H1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4243
Mailing Address - Country:US
Mailing Address - Phone:864-735-2521
Mailing Address - Fax:864-288-5340
Practice Address - Street 1:430 ROPER MOUNTAIN RD STE H1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4243
Practice Address - Country:US
Practice Address - Phone:864-735-2521
Practice Address - Fax:864-288-5340
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCJ6P3A8H7246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCJ6P3A8H7OtherNATIONAL HEALTHCAREER ASSOCIATION
SC202515OtherQUEST DIAGNOSTICS