Provider Demographics
NPI:1679514319
Name:ASBURY, BRIDGETT LOWE (MD)
Entity Type:Individual
Prefix:
First Name:BRIDGETT
Middle Name:LOWE
Last Name:ASBURY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-3639
Mailing Address - Country:US
Mailing Address - Phone:229-386-1528
Mailing Address - Fax:229-388-0556
Practice Address - Street 1:1806 LEE AVE
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-3639
Practice Address - Country:US
Practice Address - Phone:229-386-1528
Practice Address - Fax:229-388-0556
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA48452207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00866786EMedicaid
GA00866786HMedicaid
GA00866786CMedicaid
GA00866786FMedicaid
GA00866786EMedicaid
GA00866786FMedicaid