Provider Demographics
NPI:1518907807
Name:ASHFORD, MARVIN WINSTON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:WINSTON
Last Name:ASHFORD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4000 RICHARDS ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117
Mailing Address - Country:US
Mailing Address - Phone:501-758-5133
Mailing Address - Fax:501-758-5173
Practice Address - Street 1:4000 RICHARDS ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117
Practice Address - Country:US
Practice Address - Phone:501-758-3999
Practice Address - Fax:501-758-8653
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2013-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE3997207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154163001Medicaid
I05625Medicare UPIN
AR5M902Medicare ID - Type Unspecified