Healthcare Provider Details

I. General information

NPI: 1417652124
Provider Name (Legal Business Name): ASHLEY THATCHER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20751 W MARKET ST
BUCKEYE AZ
85396-7893
US

IV. Provider business mailing address

20751 W MARKET ST
BUCKEYE AZ
85396-7893
US

V. Phone/Fax

Practice location:
  • Phone: 623-463-5000
  • Fax:
Mailing address:
  • Phone: 623-463-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number012493
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: