Provider Demographics
NPI:1114987401
Name:ASHCRAFT, HAROLD G (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:G
Last Name:ASHCRAFT
Suffix:
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 1:1086 FRANKLIN ST
Mailing Address - Street 2:PATHOLOGY RM 205B
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-4305
Mailing Address - Country:US
Mailing Address - Phone:814-534-9812
Mailing Address - Fax:814-534-9372
Practice Address - Street 1:1086 FRANKLIN ST
Practice Address - Street 2:PATHOLOGY RM 205B
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-4305
Practice Address - Country:US
Practice Address - Phone:814-534-9812
Practice Address - Fax:814-534-9372
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-045155-L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0779958Medicaid
PA0779958Medicaid
PA522873Medicare ID - Type Unspecified