Provider Demographics
NPI:1255860151
Name:FARMER, ASHLEY (DMD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:DMD
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 2421
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-0041
Mailing Address - Country:US
Mailing Address - Phone:706-968-0319
Mailing Address - Fax:
Practice Address - Street 1:265 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:CLARKESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30523-6403
Practice Address - Country:US
Practice Address - Phone:706-754-2815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2017-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0153981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice