Provider Demographics
NPI:1679561567
Name:ASHLEY, HOLVOR W (MD, PHD)
Entity Type:Individual
Prefix:
First Name:HOLVOR
Middle Name:W
Last Name:ASHLEY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 310
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37815-0310
Mailing Address - Country:US
Mailing Address - Phone:423-586-3240
Mailing Address - Fax:423-581-0229
Practice Address - Street 1:850 W 3RD NORTH ST
Practice Address - Street 2:SUITE A
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3887
Practice Address - Country:US
Practice Address - Phone:423-586-3240
Practice Address - Fax:423-581-0229
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000020090207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF05025Medicare UPIN