Provider Demographics
NPI:1912431834
Name:ASHLEY, JENNIFER M (DO)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:162 BYHALIA CREEK FARMS RD E
Mailing Address - Street 2:
Mailing Address - City:BYHALIA
Mailing Address - State:MS
Mailing Address - Zip Code:38611-7065
Mailing Address - Country:US
Mailing Address - Phone:601-209-8411
Mailing Address - Fax:
Practice Address - Street 1:8990 GERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-8532
Practice Address - Country:US
Practice Address - Phone:662-893-1160
Practice Address - Fax:662-893-1166
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2024-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS27458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS27458OtherSTATE LICENSE