Provider Demographics
NPI:1790741189
Name:PERDUE, ZACK T III (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACK
Middle Name:T
Last Name:PERDUE
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-564-7084
Mailing Address - Fax:540-564-6847
Practice Address - Street 1:2006 HEALTH CAMPUS DR
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8679
Practice Address - Country:US
Practice Address - Phone:540-689-5400
Practice Address - Fax:757-579-8568
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010383762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1000870001OtherDME PROVIDER
VA008964000OtherWV MEDICAID
VA702826OtherSOUTHERN HEALTH
VA1790741189Medicaid
VA330262OtherANTHEM
VA7500281OtherCIGNA
VA1790741189OtherOPTIMA
VA1000870001OtherDME PROVIDER
VA008964000OtherWV MEDICAID