Provider Demographics
NPI:1699903021
Name:TOLER, ASHLEY R (DO)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:R
Last Name:TOLER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 COURT ST N
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-2516
Mailing Address - Country:US
Mailing Address - Phone:708-712-4948
Mailing Address - Fax:304-512-3481
Practice Address - Street 1:849 COURT ST N
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-2516
Practice Address - Country:US
Practice Address - Phone:708-712-4948
Practice Address - Fax:304-512-3481
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0102204361208000000X
WV2691208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810024989Medicaid
VA1699903021Medicaid
VA1699903021Medicaid