Provider Demographics
NPI:1245550185
Name:POULTON, GINGER JAFFERY (MD)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:JAFFERY
Last Name:POULTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:119 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2868
Mailing Address - Country:US
Mailing Address - Phone:828-257-4747
Mailing Address - Fax:828-407-2637
Practice Address - Street 1:218 ELKWOOD AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2247
Practice Address - Country:US
Practice Address - Phone:828-257-4747
Practice Address - Fax:828-257-4763
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-02263207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1245550185Medicaid
NC1245550185Medicaid