Organization
LIFEGUARD MEDICAL GROUP,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ROBERT ZACK M.D. (OWNER)
(508) 696-6863
Entity
Organization
Contact information
Practice address
72 EASTVILLE AVE, OAK BLUFFS, MA 02557
(508) 696-6863
Mailing address
PO BOX 1356, OAK BLUFFS, MA 02557-1356
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
213570
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3093018
—
MA
Enumeration date
06/14/2014
Last updated
06/26/2014
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