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General NPI Number Information
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NPI Number | 1164148243
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Entity Type | Individual
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Provider Name | ASHLYMOL GEORGE
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Gender | Female
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 1000 JOHNSON FY RD NE
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City | ATLANTA
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State | GA
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Zip | 30342-1606
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Country | US
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Telephone | 404-851-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2716 VALENCIA GROVE DR
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City | VALRICO
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State | FL
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Zip | 33596-5945
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Country | US
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Telephone | 813-481-9863
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | AA785
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | 12760
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License Number State | GA
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