Provider Demographics
NPI:1215165519
Name:ALLRED, ASHLEY WRIGHT (OD, FAAO)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:WRIGHT
Last Name:ALLRED
Suffix:
Gender:F
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 BRADFORD HICKS DR
Mailing Address - Street 2:A
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-1718
Mailing Address - Country:US
Mailing Address - Phone:931-403-3937
Mailing Address - Fax:931-403-3938
Practice Address - Street 1:1970 BRADFORD HICKS DR
Practice Address - Street 2:SUITE A
Practice Address - City:LIVINGSTON
Practice Address - State:TN
Practice Address - Zip Code:38570-1718
Practice Address - Country:US
Practice Address - Phone:931-403-3937
Practice Address - Fax:931-403-3938
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2879152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1514025Medicaid
TN6259270001Medicare NSC
TN1514025Medicaid