Basic Information
| Provider Information | |||||||||
| NPI: | 1063958015 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASHBY | ||||||||
| FirstName: | WILLIAM | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5838 SIX FORKS RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276093885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197853400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5838 SIX FORKS RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276093885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197853400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2017 | ||||||||
| LastUpdateDate: | 01/15/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 0010-06968 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.