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General NPI Number Information
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NPI Number | 1902835655
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Entity Type | Organization
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Legal Business Name | ASHLAND FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 83745 HIGHWAY 9
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City | ASHLAND
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State | AL
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Zip | 36251
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Country | US
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Telephone | 256-354-4139
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Fax | 256-354-4137
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Provider Business Mailing Address
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Address Line | PO BOX 67
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City | ASHLAND
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State | AL
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Zip | 36251-0067
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Country | US
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Telephone | 256-354-4139
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Fax | 256-354-4137
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. CHARLES DAVID HENSLEIGH
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Credential | M.D.
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Telephone | 256-354-4139
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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 | 9297
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License Number State | AL
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