Healthcare Provider Details

I. General information

NPI: 1245579424
Provider Name (Legal Business Name): CAMERON ASHLEY LOQUIST DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2013
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 DUBLIN SQUARE RD STE A
ASHEBORO NC
27203-8601
US

IV. Provider business mailing address

PO BOX 5418
ASHEBORO NC
27204-5418
US

V. Phone/Fax

Practice location:
  • Phone: 336-626-2688
  • Fax:
Mailing address:
  • Phone: 336-625-2333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4662
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0010-04101
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0102207112
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: