Provider Demographics
NPI:1194722397
Name:ASHLEY, CLAUDE T JR (MD)
Entity type:Individual
Prefix:DR
First Name:CLAUDE
Middle Name:T
Last Name:ASHLEY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 HONEYSUCKLE RD
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1140
Mailing Address - Country:US
Mailing Address - Phone:334-794-8656
Mailing Address - Fax:334-671-4957
Practice Address - Street 1:364 HONEYSUCKLE RD
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1140
Practice Address - Country:US
Practice Address - Phone:334-794-8656
Practice Address - Fax:334-671-4957
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00021645173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630738893OtherTAX ID
AL000076309Medicaid
GA00780029BMedicaid
FL254268400Medicaid
GA00780029BMedicaid