Provider Demographics
NPI:1497250963
Name:EASTERWOOD, ASHLEY MARIE (MD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE
Last Name:EASTERWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 ARCHER TRL
Mailing Address - Street 2:
Mailing Address - City:NEW BROCKTON
Mailing Address - State:AL
Mailing Address - Zip Code:36351-6173
Mailing Address - Country:US
Mailing Address - Phone:806-438-8417
Mailing Address - Fax:
Practice Address - Street 1:3217 CAPITAL MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4413
Practice Address - Country:US
Practice Address - Phone:850-320-7693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME173973207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program