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NPI Code Detail

MEDICARE: ASHTYN PERRIN OD

MEDICARE:   ASHTYN  PERRIN  OD
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
1152W00000XOptometrist0618003635VA

General Provider Information

NPI Number : 1164357836
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHTYN PERRIN OD
Provider Business Mailing Address
First Line : 3102 PLANK RD STE 395
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22407-4900
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3102 PLANK RD STE 395
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22407-4900
Country : US
Telephone Number : 540-786-2852
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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