1326536582 NPI number — ASHLEY L KIES PHD

Table of content: ASHLEY L KIES PHD (NPI 1326536582)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326536582 NPI number — ASHLEY L KIES PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIES
Provider First Name:
ASHLEY
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326536582
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
291/30 SAMMAKORN CONDOMINIUM
Provider Second Line Business Mailing Address:
112 RAMKHAMHANG ROAD
Provider Business Mailing Address City Name:
BANGKOK
Provider Business Mailing Address State Name:
SAPHAN SUNG DISTRICT
Provider Business Mailing Address Postal Code:
10240
Provider Business Mailing Address Country Code:
TH
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BROMSGROVE INTL SCHOOL 55 MU9 WINDSOR PARK GOLF CLUB
Provider Second Line Business Practice Location Address:
SUWINTHAWONG 15 ROAD
Provider Business Practice Location Address City Name:
BANGKOK
Provider Business Practice Location Address State Name:
MINBURI
Provider Business Practice Location Address Postal Code:
10510
Provider Business Practice Location Address Country Code:
TH
Provider Business Practice Location Address Telephone Number:
64-248-0689
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/24/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC1900X , with the licence number:  10399 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)