Healthcare Provider Details

I. General information

NPI: 1043570617
Provider Name (Legal Business Name): TIMOTHY DALE ASHLEY JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2012
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 COX CREEK PKWY STE B
FLORENCE AL
35630-1189
US

IV. Provider business mailing address

646 COX CREEK PKWY STE B
FLORENCE AL
35630-1189
US

V. Phone/Fax

Practice location:
  • Phone: 256-760-4544
  • Fax: 256-678-9494
Mailing address:
  • Phone: 256-760-4544
  • Fax: 256-678-9494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number193400000X
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34205
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: