Healthcare Provider Details

I. General information

NPI: 1780664235
Provider Name (Legal Business Name): RICANTHONY RENE ASHLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER RADIOLOGY
APO AE
09180
DE

IV. Provider business mailing address

CMR 402 BOX 6
APO AE
09180
DE

V. Phone/Fax

Practice location:
  • Phone: 496371867731
  • Fax:
Mailing address:
  • Phone: 496371916642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number043161
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: