Provider Demographics
NPI:1700107992
Name:SHOLES, EMILY A (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:SHOLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:REBECCA
Other - Last Name:ASHFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1000 HAWTHORNE AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2168
Mailing Address - Country:US
Mailing Address - Phone:706-286-8692
Mailing Address - Fax:
Practice Address - Street 1:1000 HAWTHORNE AVE
Practice Address - Street 2:SUITE K
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2168
Practice Address - Country:US
Practice Address - Phone:706-286-8692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4203207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology