Provider Demographics
NPI:1669523064
Name:ASHBY, CECIL E III (DC)
Entity type:Individual
Prefix:DR
First Name:CECIL
Middle Name:E
Last Name:ASHBY
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CLYDE MORRIS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8172
Mailing Address - Country:US
Mailing Address - Phone:386-672-3305
Mailing Address - Fax:800-429-7089
Practice Address - Street 1:400 CLYDE MORRIS BLVD STE C
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8172
Practice Address - Country:US
Practice Address - Phone:386-672-3305
Practice Address - Fax:800-429-7089
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0005390Medicare PIN
U64941Medicare UPIN