Provider Demographics
NPI:1194562280
Name:JAMES, ZACHARY COLVIN (OD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:COLVIN
Last Name:JAMES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 J M ASH DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:38635-3401
Mailing Address - Country:US
Mailing Address - Phone:662-252-3323
Mailing Address - Fax:
Practice Address - Street 1:185 WESLEY REED DR STE E
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-4955
Practice Address - Country:US
Practice Address - Phone:901-840-3937
Practice Address - Fax:901-840-3395
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1089P-Y152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist