Healthcare Provider Details

I. General information

NPI: 1780654764
Provider Name (Legal Business Name): DEBORAH ASHWORTH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1036 HIGHWAY 64 E
ALMA AR
72921-6807
US

IV. Provider business mailing address

4505 N RUDY RD
VAN BUREN AR
72956-9062
US

V. Phone/Fax

Practice location:
  • Phone: 479-651-3389
  • Fax: 479-474-4044
Mailing address:
  • Phone: 479-651-3389
  • Fax: 479-397-4870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number806
License Number StateAR

VIII. Authorized Official

Name: DEBORAH LYNN ASHWORTH
Title or Position: OWNER
Credential: PT
Phone: 479-651-3389