Provider Demographics
NPI:1619924180
Name:GUY, ASHLEY ESHAM (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ESHAM
Last Name:GUY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:RUTH
Other - Last Name:ESHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:394 FRUIT TREE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-7162
Mailing Address - Country:US
Mailing Address - Phone:251-408-1700
Mailing Address - Fax:251-633-1997
Practice Address - Street 1:6801 AIRPORT BLVD
Practice Address - Street 2:EMERGENCY DEPT
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3709
Practice Address - Country:US
Practice Address - Phone:251-633-1900
Practice Address - Fax:251-633-1997
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA-329363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I970061OtherMEDICARE
AL511-35523OtherBLUE CROSS
AL148739Medicaid