Provider Demographics
NPI:1255851812
Name:HEMPHILL, ASHLEY SHEA (OD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SHEA
Last Name:HEMPHILL
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:PO BOX 207158
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-7158
Mailing Address - Country:US
Mailing Address - Phone:636-200-4393
Mailing Address - Fax:636-527-0766
Practice Address - Street 1:1028 TOWN AND COUNTRY CROSSING DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-0610
Practice Address - Country:US
Practice Address - Phone:636-230-9190
Practice Address - Fax:636-230-9019
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017019229152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist