Provider Demographics
NPI:1710203971
Name:LINER, ZACHARY JEFFERSON (MD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:JEFFERSON
Last Name:LINER
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 2668
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-2668
Mailing Address - Country:US
Mailing Address - Phone:985-230-6700
Mailing Address - Fax:985-230-1528
Practice Address - Street 1:1340 BROAD AVE STE 440
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2460
Practice Address - Country:US
Practice Address - Phone:228-867-4855
Practice Address - Fax:228-867-4870
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3051782085R0202X, 2085R0204X, 2085N0700X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology