Healthcare Provider Details

I. General information

NPI: 1114718137
Provider Name (Legal Business Name): ROB ASHBY MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 CROSSINGS DR
PRESCOTT AZ
86305-7190
US

IV. Provider business mailing address

2238 W MOUNTAIN OAK RD
PRESCOTT AZ
86305-8774
US

V. Phone/Fax

Practice location:
  • Phone: 928-778-5097
  • Fax: 407-633-7536
Mailing address:
  • Phone: 602-821-5755
  • Fax: 407-633-7536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROB ASHBY
Title or Position: OWNER
Credential: MD
Phone: 602-821-5755