Provider Demographics
NPI:1164416814
Name:ASHCRAFT, JIMMIE LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JIMMIE
Middle Name:LEE
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:RR 2
Mailing Address - Street 2:BOX 2162
Mailing Address - City:SIDNEY
Mailing Address - State:MT
Mailing Address - Zip Code:59270-9802
Mailing Address - Country:US
Mailing Address - Phone:406-482-4272
Mailing Address - Fax:
Practice Address - Street 1:123 S 27TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-4200
Practice Address - Country:US
Practice Address - Phone:406-247-3350
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTD90287Medicare UPIN