MEDICARE: DR. ALONZO ASHTON 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	5654	NV

General Provider Information

NPI Number	:	1811083637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALONZO ASHTON M.D.

Provider Business Mailing Address
First Line	:	2576 LEIGH AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-1830
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3059 S MARYLAND PKWY
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2294
Country	:	US
Telephone Number	:	801-735-8078
Fax Number	:

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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