Provider Demographics
NPI:1093769036
Name:ASHLEY, DONALD RAY SR (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:RAY
Last Name:ASHLEY
Suffix:SR
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 1:1800 BIRMINGHAM AVE
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-5461
Mailing Address - Country:US
Mailing Address - Phone:205-384-4585
Mailing Address - Fax:205-384-4428
Practice Address - Street 1:1800 BIRMINGHAM AVE
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-5461
Practice Address - Country:US
Practice Address - Phone:205-384-4458
Practice Address - Fax:205-384-4428
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13532207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051506335Medicaid
AL051506335Medicare ID - Type Unspecified
AL051506335Medicaid