Provider Demographics
NPI:1225326242
Name:SHARP, ASHLEY BRILLAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BRILLAN
Last Name:SHARP
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 E 62ND ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-2958
Mailing Address - Country:US
Mailing Address - Phone:317-257-4444
Mailing Address - Fax:
Practice Address - Street 1:2710 E 62ND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-2958
Practice Address - Country:US
Practice Address - Phone:317-257-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR-225-TA-983152W00000X
KY1841DT152W00000X
IN18003714AB152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist