Provider Demographics
NPI:1720165798
Name:ASHLEY, LENORA M (MD)
Entity Type:Individual
Prefix:
First Name:LENORA
Middle Name:M
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LENORA
Other - Middle Name:MARGARET
Other - Last Name:ASHLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7000 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:BLDG 16 S-100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:770-393-1880
Mailing Address - Fax:770-393-1885
Practice Address - Street 1:7000 PEACHTREE DUNWOODY RD
Practice Address - Street 2:BLDG 16 S-100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:770-393-1880
Practice Address - Fax:770-393-1885
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0316982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00512025AMedicaid
26BDCXGMedicare ID - Type Unspecified
GA00512025AMedicaid