Provider Demographics
NPI:1821013004
Name:ASH, ANN STEVENS (MD)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:STEVENS
Last Name:ASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:CECILIA
Other - Middle Name:ANN
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4600 S PARK AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85714-1697
Mailing Address - Country:US
Mailing Address - Phone:520-889-9574
Mailing Address - Fax:
Practice Address - Street 1:4600 S PARK AVE STE 5
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-1697
Practice Address - Country:US
Practice Address - Phone:520-889-9574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20681207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ133664Medicare UPIN
AZZ120952Medicare PIN
C72832Medicare UPIN
AZZ133663Medicare UPIN
AZZ120970Medicare UPIN
AZZ126048Medicare PIN