Provider Demographics
NPI:1003257163
Name:ASHFORD, KALEN ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:KALEN
Middle Name:ELIZABETH
Last Name:ASHFORD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1061 DOWDY RD STE 202
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-5700
Mailing Address - Country:US
Mailing Address - Phone:706-389-8941
Mailing Address - Fax:706-389-8942
Practice Address - Street 1:1061 DOWDY RD STE 202
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5700
Practice Address - Country:US
Practice Address - Phone:706-389-8941
Practice Address - Fax:706-389-8942
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2020-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCPA030954363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical