Provider Demographics
NPI:1659759108
Name:SALVAGGIO, ASHLEY PREVOST (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PREVOST
Last Name:SALVAGGIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1211 UNION AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7235 HACKS CROSS RD
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-4213
Practice Address - Country:US
Practice Address - Phone:662-893-7878
Practice Address - Fax:662-874-1391
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN58334207Q00000X
MS26539207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine