MEDICARE: ASHTON WILSON GRAVES

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	363LF0000X	Family Nurse Practitioner	906796	MS

General Provider Information

NPI Number	:	1578300851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHTON WILSON GRAVES

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	601-200-4800
Fax Number	:	225-765-4278

Provider Business Practice Location Address
First Line	:	728 CLINTON PKWY STE B
Second Line	:
City	:	CLINTON
State	:	MS
Zip	:	39056-5227
Country	:	US
Telephone Number	:	601-200-4800
Fax Number	:

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

Provider Enumeration Date	:	07/12/2024
Last Update Date	:	08/16/2024

Similar Medicare Providers

1780652362 — JODY T ADAMS CFNP
Practice Location Address:

728 CLINTON PKWY , SUITE B
CLINTON, MS
39056-5227

Practice Phone: 601-200-4800
Practice Fax: 601-924-0473

1184778508 — DR. ARTURO ENRIQUE BLANCO MD
Practice Location Address:

728 CLINTON PKWY STE B
CLINTON, MS
39056-5227

Practice Phone: 601-200-4800
Practice Fax: 601-200-4805

1437388055 — DR. SCOTT CHASLEY MARTIN M.D.
Practice Location Address:

732 CLINTON PKWY
CLINTON, MS
39056-5227

Practice Phone: 601-924-7994
Practice Fax: 601-924-7671

1184946170 — ELIZABETH CLARK ALLEN CFNP
Practice Location Address:

728 CLINTON PKWY STE B
CLINTON, MS
39056-5227

Practice Phone: 601-200-4800
Practice Fax: 601-200-4805

1376951921 — JENNIFER RUSSUM
Practice Location Address:

732 CLINTON PKWY
CLINTON, MS
39056-5227

Practice Phone: 601-924-7994
Practice Fax:

1699320028 — EYEGLASSES ONLINE DIRECT
Practice Location Address:

41975 BROOKVIEW LN
CLINTON TOWNSHIP, MI
48038-5227

Practice Phone: 586-915-7465
Practice Fax:

Directions to “ ASHTON WILSON GRAVES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.