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NPI Code Detail

MEDICARE: TEIGHLOR NICOLE ASHBURN DO

MEDICARE: TEIGHLOR NICOLE ASHBURN DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramGA

General Provider Information

NPI Number : 1023959731
Entity Type Code : Individual
Provider Name (Legal Business Name) : TEIGHLOR NICOLE ASHBURN DO
Provider Business Mailing Address
First Line : 2501 N PATTERSON ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-1735
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2501 N PATTERSON ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-1735
Country : US
Telephone Number : 229-433-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ TEIGHLOR NICOLE ASHBURN DO” Practice Location

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