Provider Demographics
NPI:1063411825
Name:ASHLEY, JOHN ROBERT (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ROBERT
Last Name:ASHLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6600 S YALE AVE STE 1400
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3331
Mailing Address - Country:US
Mailing Address - Phone:918-502-3376
Mailing Address - Fax:918-502-3375
Practice Address - Street 1:6565 S YALE AVE STE 1200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8313
Practice Address - Country:US
Practice Address - Phone:918-502-3376
Practice Address - Fax:918-857-1961
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2021-10-12
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Provider Licenses
StateLicense IDTaxonomies
OK13846207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100123530CMedicaid