Provider Demographics
NPI:1033134283
Name:ASHLEY, CARLENE D (DO)
Entity Type:Individual
Prefix:
First Name:CARLENE
Middle Name:D
Last Name:ASHLEY
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 1:110 HUFFARD DR
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-9209
Mailing Address - Country:US
Mailing Address - Phone:276-326-3376
Mailing Address - Fax:276-326-2141
Practice Address - Street 1:110 HUFFARD DR
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-9209
Practice Address - Country:US
Practice Address - Phone:276-326-3376
Practice Address - Fax:276-326-2141
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201834208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0102201834OtherVIRGINIA LICENSE