Healthcare Provider Details

I. General information

NPI: 1316385388
Provider Name (Legal Business Name): ASHLEY L GABBARD D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 W EVERLY BROTHERS BLVD STE 2A
POWDERLY KY
42367-5401
US

IV. Provider business mailing address

PO BOX 23229
OWENSBORO KY
42304-3229
US

V. Phone/Fax

Practice location:
  • Phone: 270-377-2626
  • Fax: 270-377-2777
Mailing address:
  • Phone: 270-688-1330
  • Fax: 270-688-1338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number03948
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: