Provider Demographics
NPI:1538459458
Name:ASHLEY, DAVID HOUSTON (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HOUSTON
Last Name:ASHLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 BRKWD MED CTR DR STE 24
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6809
Mailing Address - Country:US
Mailing Address - Phone:205-870-1009
Mailing Address - Fax:
Practice Address - Street 1:2045 BRKWD MED CTR DR STE 24
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6809
Practice Address - Country:US
Practice Address - Phone:205-870-1009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6238122300000X
VA04014168691223S0112X
MD169321223S0112X
SC94961223S0112X
MS3909-171223S0112X
LA67191223S0112X
AL31809208D00000X
TX371941223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice