Healthcare Provider Details

I. General information

NPI: 1639160849
Provider Name (Legal Business Name): ERIC JOSEPH ASHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

262 N BINKLEY ST
SOLDOTNA AK
99669-7522
US

IV. Provider business mailing address

250 HOSPITAL PL
SOLDOTNA AK
99669-7559
US

V. Phone/Fax

Practice location:
  • Phone: 907-714-4090
  • Fax: 855-712-3955
Mailing address:
  • Phone: 907-714-4038
  • Fax: 907-262-5191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number022817
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: