Provider Demographics
NPI:1952371445
Name:ASHBERY, THOMAS E (DPM)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:ASHBERY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10250 CARNEGIE CLUB DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-9001
Mailing Address - Country:US
Mailing Address - Phone:901-681-9141
Mailing Address - Fax:
Practice Address - Street 1:1038 S YATES RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3708
Practice Address - Country:US
Practice Address - Phone:901-681-9141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN344213E00000X
AR123213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR118594748Medicaid
TN480010757OtherMEDICARE ID TYPE UNSPECIFIED
TN480010757OtherMEDICARE ID TYPE UNSPECIFIED
U01894Medicare UPIN