Basic Information
| Provider Information | |||||||||
| NPI: | 1922417237 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMILY ASHLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13000 RIVERS BEND BLVD | ||||||||
| Address2: | SUITE C | ||||||||
| City: | CHESTER | ||||||||
| State: | VA | ||||||||
| PostalCode: | 238368632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8045715000 | ||||||||
| FaxNumber: | 8045181314 | ||||||||
| Practice Location | |||||||||
| Address1: | 95 MEDICAL PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | PETERSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 238059280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8045048100 | ||||||||
| FaxNumber: | 8048610050 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2014 | ||||||||
| LastUpdateDate: | 08/12/2014 | ||||||||
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| AuthorizedOfficialLastName: | BAGGA | ||||||||
| AuthorizedOfficialFirstName: | SILKY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER/PRACTITIONER | ||||||||
| AuthorizedOfficialTelephone: | 8045715000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101-246465 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.