Provider Demographics
NPI:1497250963
Name:EASTERWOOD, ASHLEY MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:EASTERWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E BRUNSON ST STE 310
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-2500
Mailing Address - Country:US
Mailing Address - Phone:334-393-0737
Mailing Address - Fax:334-393-0737
Practice Address - Street 1:101 E BRUNSON ST STE 310
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2500
Practice Address - Country:US
Practice Address - Phone:334-393-0737
Practice Address - Fax:334-393-0914
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ALMD.38860207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program