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General NPI Number Information
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NPI Number | 1508779067
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Entity Type | Individual
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Provider Name | ASHLEY MYLES
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Gender | Female
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 5095 JEFFERSON RD
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City | ATHENS
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State | GA
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Zip | 30607-1753
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Country | US
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Telephone | 706-850-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 1407 OAK GROVE RD
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City | LANDRUM
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State | SC
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Zip | 29356-9346
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Country | US
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Telephone |
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MYLE-2C869U
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License Number State | GA
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