Provider Demographics
NPI:1144419128
Name:RALPH G. ASBURY, MD, APMC
Entity Type:Organization
Organization Name:RALPH G. ASBURY, MD, APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ASBURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-323-2313
Mailing Address - Street 1:2713 OAK DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2432
Mailing Address - Country:US
Mailing Address - Phone:318-323-2313
Mailing Address - Fax:318-387-6618
Practice Address - Street 1:6198 CYPRESS ST
Practice Address - Street 2:BUILDING 2
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-9010
Practice Address - Country:US
Practice Address - Phone:318-397-6360
Practice Address - Fax:318-397-6399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD012782207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1155713Medicaid
LA5CM31Medicare PIN