Provider Demographics
NPI:1407274426
Name:MCGLAWN, ASHLEY W (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:W
Last Name:MCGLAWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:L
Other - Last Name:WINFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:401 BAPTIST DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-2009
Mailing Address - Country:US
Mailing Address - Phone:601-856-2598
Mailing Address - Fax:601-856-4459
Practice Address - Street 1:401 BAPTIST DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-2009
Practice Address - Country:US
Practice Address - Phone:601-856-2598
Practice Address - Fax:601-856-4459
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS24899208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
87726OtherINSURANCE
412MPOtherINSURANCE
64069OtherINSURANCE
TRESTOtherINSURANCE
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6400OtherINSURANCE
41124OtherINSURANCE
3429OtherINSURANCE
SB730OtherINSURANCE