Provider Demographics
NPI:1982643599
Name:ASHTON, ALEX N (PAC)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:N
Last Name:ASHTON
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4743 ARAPAHOE AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1113
Mailing Address - Country:US
Mailing Address - Phone:303-938-5700
Mailing Address - Fax:303-998-0007
Practice Address - Street 1:4743 ARAPAHOE AVE
Practice Address - Street 2:STE 202
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1113
Practice Address - Country:US
Practice Address - Phone:303-938-5700
Practice Address - Fax:303-998-0007
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO1691363AS0400X
COPA 1691363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q18899Medicare UPIN
COC539798Medicare PIN
COC441038Medicare PIN