Provider Demographics
NPI:1659687507
Name:ROBERT G. ASHLEY, M.D., P.A.
Entity Type:Organization
Organization Name:ROBERT G. ASHLEY, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:GRADY
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:352-331-3300
Mailing Address - Street 1:6800 NW 9TH BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4231
Mailing Address - Country:US
Mailing Address - Phone:352-331-3300
Mailing Address - Fax:
Practice Address - Street 1:6800 NW 9TH BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4231
Practice Address - Country:US
Practice Address - Phone:352-331-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0020234261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100129OtherAVMED
FL78194OtherBCBS
FL78194OtherBCBS