Provider Demographics
NPI:1831308899
Name:WAUGH, ASHLEE MICHELLE (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:MICHELLE
Last Name:WAUGH
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 1:1701 E 2ND
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6387
Mailing Address - Country:US
Mailing Address - Phone:405-348-2323
Mailing Address - Fax:405-348-2325
Practice Address - Street 1:1701 E 2ND
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6387
Practice Address - Country:US
Practice Address - Phone:405-348-2323
Practice Address - Fax:405-348-2325
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26007207R00000X
VA0116016556390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program