Provider Demographics
NPI:1467477265
Name:MOWL, ASHLEY D (OD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:D
Last Name:MOWL
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 1:950 SOUTH CENTRAL AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317
Mailing Address - Country:US
Mailing Address - Phone:724-745-2020
Mailing Address - Fax:724-745-4888
Practice Address - Street 1:950 SOUTH CENTRAL AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317
Practice Address - Country:US
Practice Address - Phone:724-745-2020
Practice Address - Fax:724-745-4888
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001894152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1019644700002Medicaid
PAV10765Medicare UPIN
PA1019644700002Medicaid