MEDICARE: ASHTON LYND GRAYBIEL M.D.

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	207RR0500X	Rheumatology Physician	ME0019255	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME0019255	OTHER	FL	MEDICAL LICENSURE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	59002286	OTHER	AL	BC BS ALABAMA
4	3206912	OTHER	FL	UNITED HEALTH CARE

General Provider Information

NPI Number	:	1689724130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHTON LYND GRAYBIEL M.D.

Provider Business Mailing Address
First Line	:	2441 N 9TH AVE
Second Line	:	SUITE A
City	:	PENSACOLA
State	:	FL
Zip	:	32503-3911
Country	:	US
Telephone Number	:	850-434-9992
Fax Number	:	850-435-2525

Provider Business Practice Location Address
First Line	:	2441 N 9TH AVE
Second Line	:	SUITE A
City	:	PENSACOLA
State	:	FL
Zip	:	32503-3911
Country	:	US
Telephone Number	:	850-434-9992
Fax Number	:	850-435-2525

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	09/16/2015

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