Provider Demographics
NPI:1841993540
Name:ASHCRAFT, ROBERT KENNETH
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:KENNETH
Last Name:ASHCRAFT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BUENA VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-3975
Mailing Address - Country:US
Mailing Address - Phone:304-203-7875
Mailing Address - Fax:
Practice Address - Street 1:206 BUENA VISTA AVE
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-3975
Practice Address - Country:US
Practice Address - Phone:304-203-7875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant