Provider Demographics
NPI:1568449486
Name:BURTON, ASHBY JEFFRIES III (MD)
Entity Type:Individual
Prefix:
First Name:ASHBY
Middle Name:JEFFRIES
Last Name:BURTON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:A.
Other - Middle Name:JEFF
Other - Last Name:BURTON
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:129 THREE CHOPT RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NC
Mailing Address - Zip Code:27850-8071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:129 THREE CHOPT RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NC
Practice Address - Zip Code:27850-8071
Practice Address - Country:US
Practice Address - Phone:252-586-2105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28738207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0154634OtherUNITED HEALTH CARE
NC28738OtherNORTH CAROLINA LICENSE #
NCAB2292530OtherDEA NUMBER
NC20226OtherBLUE CROSS BLUE SHIELD
NC8920226Medicaid
NC80278OtherMEDCOST, LLC
NCE09530Medicare UPIN
NC205174HMedicare ID - Type UnspecifiedCIGNA MEDICARE