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Individual

ASHLEY ROE JESSIE MATNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1704 W STOCKTON ST, EDMONTON, KY 42129-8137
(270) 432-4800
(270) 432-4804
Mailing address
1704 W STOCKTON ST, EDMONTON, KY 42129-8137
(270) 432-4800
(270) 432-4804

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48197
KY
208000000X
Pediatrics Physician
48197
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100358370
KY
Enumeration date
05/19/2011
Last updated
03/02/2023
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