Provider Demographics
NPI:1508489246
Name:ASBURY, ZACKERY ERIC (MD)
Entity type:Individual
Prefix:
First Name:ZACKERY
Middle Name:ERIC
Last Name:ASBURY
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:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:DAVIN
Mailing Address - State:WV
Mailing Address - Zip Code:25617-0114
Mailing Address - Country:US
Mailing Address - Phone:304-942-7633
Mailing Address - Fax:
Practice Address - Street 1:600 E MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:MAN
Practice Address - State:WV
Practice Address - Zip Code:25635-1023
Practice Address - Country:US
Practice Address - Phone:304-583-8585
Practice Address - Fax:304-583-0129
Is Sole Proprietor?:No
Enumeration Date:2020-05-28
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV31508207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine