Basic Information
Provider Information
NPI: 1598146953
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOWNSEND
FirstName: ASHTON
MiddleName: SCOTT
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 742616
Address2:  
City: ATLANTA
State: GA
PostalCode: 303742616
CountryCode: US
TelephoneNumber: 7702198420
FaxNumber:  
Practice Location
Address1: 743 SPRING ST NE
Address2:  
City: GAINESVILLE
State: GA
PostalCode: 30501
CountryCode: US
TelephoneNumber: 7702199000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/11/2015
LastUpdateDate: 08/28/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XLL37655SCN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X081100GAY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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