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NPI Code Detail

MEDICARE: DR. BRYANT ASHLEY, JR.

MEDICARE: DR. BRYANT ASHLEY, JR.
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
1152W00000XOptometrist2334AR

General Provider Information

NPI Number : 1942381587
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. BRYANT ASHLEY, JR.
Provider Business Mailing Address
First Line : 3418 CAMP ROBINSON RD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72118-5051
Country : US
Telephone Number : 501-758-1015
Fax Number : 501-758-1554
Provider Business Practice Location Address
First Line : 3418 CAMP ROBINSON RD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72118-5051
Country : US
Telephone Number : 501-758-1015
Fax Number : 501-758-1554
Authorized Official
Title or Position : OWNER
Name : DR. BRYANT B. ASHLEY JR.
Credential : O.D.
Telephone Number : 501-758-1015
Provider Enumeration Date : 10/18/2006
Last Update Date : 03/11/2008

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Directions to “DR. BRYANT ASHLEY, JR. ” Practice Location

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