Provider Demographics
NPI:1073240917
Name:ASHFORD ORTHOPEDIC SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ASHFORD ORTHOPEDIC SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-372-2983
Mailing Address - Street 1:1061 DOWDY RD STE 220
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 1:3955 HARRISON RD STE 200A
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-8502
Practice Address - Country:US
Practice Address - Phone:706-389-8941
Practice Address - Fax:706-389-8942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty