Provider Demographics
NPI:1689631400
Name:MURPHREE, ASHLEY MOTT (PT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MOTT
Last Name:MURPHREE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:PHILLIPS
Other - Last Name:MOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:300 SOUTHWEST SQ
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401
Mailing Address - Country:US
Mailing Address - Phone:870-336-0220
Mailing Address - Fax:870-336-0221
Practice Address - Street 1:300 SOUTHWEST SQ
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-336-0220
Practice Address - Fax:870-336-0221
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2638174400000X
ARPT2636174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X780OtherBCBS
AR5X780OtherBLUECROSS PROVIDER #
AR138331721Medicaid