Provider Demographics
NPI:1184261299
Name:ASHFORD, CHESTER ARTHUR JR
Entity type:Individual
Prefix:MR
First Name:CHESTER
Middle Name:ARTHUR
Last Name:ASHFORD
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10257 EVENINGHILL DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0334
Mailing Address - Country:US
Mailing Address - Phone:901-652-5290
Mailing Address - Fax:
Practice Address - Street 1:10257 EVENINGHILL DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0334
Practice Address - Country:US
Practice Address - Phone:901-652-5290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN065891590171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor