Healthcare Provider Details

I. General information

NPI: 1780229310
Provider Name (Legal Business Name): WILLIAM RONAN ASH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2019
Last Update Date: 11/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5671 PEACHTREE DUNWOODY RD STE 610
ATLANTA GA
30342-5013
US

IV. Provider business mailing address

5671 PEACHTREE DUNWOODY RD STE 610
ATLANTA GA
30342-5013
US

V. Phone/Fax

Practice location:
  • Phone: 404-257-1415
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number240715
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: