Provider Demographics
NPI:1659347045
Name:JONES-ASHMORE, MELISSA ELLEN (P A - C)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ELLEN
Last Name:JONES-ASHMORE
Suffix:
Gender:F
Credentials:P A - C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 MILFORD CHURCH RD SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-5034
Mailing Address - Country:US
Mailing Address - Phone:678-296-9362
Mailing Address - Fax:
Practice Address - Street 1:3875 AUSTELL RD STE 101
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1153
Practice Address - Country:US
Practice Address - Phone:770-941-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001886363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant