MEDICARE: TIMOTHY ELBERT ASHMORE M.D.

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	207Q00000X	Family Medicine Physician	MD31692	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00332873	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	4109850	OTHER	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4106020	OTHER	BCBS

General Provider Information

NPI Number	:	1154369320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY ELBERT ASHMORE M.D.

Provider Business Mailing Address
First Line	:	175 HOSPITAL DR
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320-1617
Country	:	US
Telephone Number	:	731-593-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 HOSPITAL DR
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320-1617
Country	:	US
Telephone Number	:	731-593-6300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	04/11/2019

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