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NPI Code Detail

MEDICARE: ASHLEY DELO PA

MEDICARE:   ASHLEY  DELO  PA
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
1363AM0700XMedical Physician AssistantAR

General Provider Information

NPI Number : 1285180281
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY DELO PA
Provider Business Mailing Address
First Line : 105 MCNEIL ST
Second Line :
City : BENTON
State : AR
Zip : 72015-3345
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 105 MCNEIL ST
Second Line :
City : BENTON
State : AR
Zip : 72015-3345
Country : US
Telephone Number : 501-315-1222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2016
Last Update Date : 07/17/2025

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Directions to “ ASHLEY DELO PA” Practice Location

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