Provider Demographics
NPI:1922872175
Name:DAVIS, ASHTON (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHTON
Other - Middle Name:
Other - Last Name:SHEPHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2541 NORTHWOLD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-5991
Mailing Address - Country:US
Mailing Address - Phone:937-554-7599
Mailing Address - Fax:
Practice Address - Street 1:7774 DAYTON SPRINGFIELD RD
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-1957
Practice Address - Country:US
Practice Address - Phone:937-864-7363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.008506RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical