Healthcare Provider Details
I. General information
NPI: 1821018268
Provider Name (Legal Business Name): ASHURST FAMILY PHYSICIANS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
23659 COLUMBUS RD SUITE 4
COLUMBUS NJ
08022-1979
US
IV. Provider business mailing address
1564 ROUTE 38 SUITE 6A
LUMBERTON NJ
08048-2939
US
V. Phone/Fax
- Phone: 609-702-5510
- Fax: 609-267-0642
- Phone: 609-298-3304
- Fax: 609-298-7091
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
J.
BROSS
Title or Position: PRESIDENT
Credential: MD
Phone: 609-702-5510