Provider Demographics
NPI:1194110197
Name:SHEPARD, ASHLEY LEE (DO)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LEE
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LEE
Other - Last Name:DOTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:137 FLORISSANT AVE
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4225
Mailing Address - Country:US
Mailing Address - Phone:814-558-1901
Mailing Address - Fax:
Practice Address - Street 1:600 WORCESTER RD STE 201
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5360
Practice Address - Country:US
Practice Address - Phone:508-845-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2869382084P0800X, 2084A0401X
PAOS0184552084P0800X
WI29812084P0800X
IL0361703332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS018455OtherOSTEOPATHIC MEDICAL LICENSE
MA286938OtherOSTEOPATHIC MEDICAL LICENSE