MEDICARE: ASHLAND SURGICAL ASSOCIATES, INC

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
1	208600000X	Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053494575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASHLAND SURGICAL ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	PO BOX 22958
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44122-0958
Country	:	US
Telephone Number	:	216-595-9600
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 HILLCREST DR
Second Line	:
City	:	ASHLAND
State	:	OH
Zip	:	44805-4052
Country	:	US
Telephone Number	:	419-281-0451
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARY CAREY MACDONALD
Credential	:	M.D.
Telephone Number	:	419-281-0451

Provider Enumeration Date	:	10/21/2006
Last Update Date	:	08/22/2020

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