Provider Demographics
NPI:1588692636
Name:ASHFORD, WILLIAM CLAY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CLAY
Last Name:ASHFORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BAPTIST DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-2030
Mailing Address - Country:US
Mailing Address - Phone:601-985-9120
Mailing Address - Fax:601-985-9122
Practice Address - Street 1:501 BAPTIST DR
Practice Address - Street 2:SUITE 220
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-2030
Practice Address - Country:US
Practice Address - Phone:601-985-9120
Practice Address - Fax:601-985-9122
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS07279207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00017578Medicaid
MS181948351OtherPTAN
MSB66012Medicare UPIN