Provider Demographics
NPI:1568713360
Name:ASHLEY DEWITT DO PC
Entity Type:Organization
Organization Name:ASHLEY DEWITT DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-962-0450
Mailing Address - Street 1:161 SHIRLEY DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2256
Mailing Address - Country:US
Mailing Address - Phone:931-962-0450
Mailing Address - Fax:931-962-0470
Practice Address - Street 1:161 SHIRLEY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2256
Practice Address - Country:US
Practice Address - Phone:931-962-0450
Practice Address - Fax:931-962-0470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2396207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty