Provider Demographics
NPI:1518207950
Name:ADES, ASHLEY M (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:ADES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:JARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:835 COGBURN AVE NW
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1001
Mailing Address - Country:US
Mailing Address - Phone:770-422-5557
Mailing Address - Fax:770-422-5456
Practice Address - Street 1:835 COGBURN AVE NW
Practice Address - Street 2:SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1001
Practice Address - Country:US
Practice Address - Phone:770-422-5557
Practice Address - Fax:770-422-5456
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7875363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I971400Medicare PIN