Provider Demographics
NPI:1942400403
Name:PULLEN, ASHLEY BURLESON (MD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BURLESON
Last Name:PULLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9446
Mailing Address - Country:US
Mailing Address - Phone:901-227-3255
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:2173 MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6309
Practice Address - Country:US
Practice Address - Phone:601-605-3835
Practice Address - Fax:601-605-3898
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS20772207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine