MEDICARE: CYNTHIA K ASHCRAFT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	C6785	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306833215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA K ASHCRAFT MD

Provider Business Mailing Address
First Line	:	PO BOX 402330
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-2330
Country	:	US
Telephone Number	:	479-709-7399
Fax Number	:	479-709-7053

Provider Business Practice Location Address
First Line	:	1501 S WALDRON RD
Second Line	:	STE 100
City	:	FORT SMITH
State	:	AR
Zip	:	72903-2574
Country	:	US
Telephone Number	:	479-709-7337
Fax Number	:	479-709-7461

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	08/13/2010

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