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General NPI Number Information
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NPI Number | 1841415858
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Entity Type | Individual
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Provider Name | ASHLI PHILLIPS ALEXANDER M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 06/20/2019
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Provider Practice Location Address
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Address Line | 11 UPPER RIVERDALE SW RD
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City | RIVERDALE
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State | GA
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Zip | 30274
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Country | US
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Telephone | 770-996-3190
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Fax | 770-996-3529
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Provider Business Mailing Address
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Address Line | PO BOX 306
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-0306
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Country | US
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Telephone | 678-552-6269
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 001966
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 001966
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License Number State | GA
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