Provider Demographics
NPI:1669413290
Name:JANNEY, ASHLEY LANE (MD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LANE
Last Name:JANNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6721 THOMASVILLE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-4875
Mailing Address - Country:US
Mailing Address - Phone:850-431-9000
Mailing Address - Fax:850-431-9001
Practice Address - Street 1:6721 THOMASVILLE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-4875
Practice Address - Country:US
Practice Address - Phone:850-431-9000
Practice Address - Fax:850-431-9001
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69202207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252892400Medicaid
FL080146875OtherRAIL ROAD
FL0771280001Medicare NSC
FL080146875OtherRAIL ROAD
FLG60011Medicare UPIN