Healthcare Provider Details

I. General information

NPI: 1346593175
Provider Name (Legal Business Name): ASHLEY R LANCASTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2012
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 N CENTER ST
HICKORY NC
28601-1853
US

IV. Provider business mailing address

900 MOHAWK STREET STE E
SAVANNAH GA
31419
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-7546
  • Fax: 828-322-9927
Mailing address:
  • Phone: 912-925-0067
  • Fax: 912-925-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number07610
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: