MEDICARE: DR. TIMOTHY MARK ASHBURN 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	207R00000X	Internal Medicine Physician	68698	GA
2	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	68698	GA
3	207RP1001X	Pulmonary Disease Physician	68698	GA

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	:	1417242264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY MARK ASHBURN M.D.

Provider Business Mailing Address
First Line	:	4635 BATTLEFIELD PKWY
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-8011
Country	:	US
Telephone Number	:	706-841-0833
Fax Number	:	706-841-0020

Provider Business Practice Location Address
First Line	:	4635 BATTLEFIELD PKWY
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-8011
Country	:	US
Telephone Number	:	706-841-0833
Fax Number	:	706-841-0020

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

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	01/24/2024

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