Healthcare Provider Details

I. General information

NPI: 1932317856
Provider Name (Legal Business Name): ASHLEY FOUST GILMER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UT COLLEGE OF MEDICINE 920 MADISON AVE. SUITE 350
MEMPHIS TN
38163-0001
US

IV. Provider business mailing address

1061 W MONTEBELLO CIR
CORDOVA TN
38018-8403
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-5364
  • Fax:
Mailing address:
  • Phone: 901-757-3949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number39020000X
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: