Provider Demographics
NPI:1851555478
Name:ASHBY, DALLEN (MD)
Entity Type:Individual
Prefix:
First Name:DALLEN
Middle Name:
Last Name:ASHBY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-7662
Mailing Address - Country:US
Mailing Address - Phone:716-338-3607
Mailing Address - Fax:
Practice Address - Street 1:10 TIMBER LN
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-7662
Practice Address - Country:US
Practice Address - Phone:716-338-3607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-13
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2579142085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging