Provider Demographics
NPI:1043476757
Name:DE WITT, ASHLEY (DO)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DE WITT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 HOSPITAL RD STE C
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2495
Mailing Address - Country:US
Mailing Address - Phone:931-962-3297
Mailing Address - Fax:931-967-0175
Practice Address - Street 1:155 HOSPITAL RD STE C
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-2495
Practice Address - Country:US
Practice Address - Phone:931-962-3297
Practice Address - Fax:931-967-0175
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN2396207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program