Provider Demographics
NPI:1043026834
Name:SCRUGGS-POOLE, ASHTON JAICE
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:JAICE
Last Name:SCRUGGS-POOLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 STILL WATER CIR
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-4828
Mailing Address - Country:US
Mailing Address - Phone:678-469-1128
Mailing Address - Fax:
Practice Address - Street 1:100 BRUNSWICK MEDICAL CENTER PKWY NE
Practice Address - Street 2:
Practice Address - City:BOLIVIA
Practice Address - State:NC
Practice Address - Zip Code:28422-1001
Practice Address - Country:US
Practice Address - Phone:910-253-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program