Provider Demographics
NPI:1942458955
Name:MARK A ASHBY MD PA
Entity type:Organization
Organization Name:MARK A ASHBY MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MYEASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-382-3914
Mailing Address - Street 1:2821 ALT US 27 S
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-4972
Mailing Address - Country:US
Mailing Address - Phone:863-382-3914
Mailing Address - Fax:863-402-0700
Practice Address - Street 1:2821 ALTERNATE US HWY 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870
Practice Address - Country:US
Practice Address - Phone:863-382-3914
Practice Address - Fax:855-483-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009285800Medicaid
FLE22452Medicare UPIN
FL371901400Medicaid