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ASHLEY JOY PEDIGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A

Contact information

Practice address
4506 1ST AVE, EVANSVILLE, IN 47710
(812) 428-6161
(812) 421-2883
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-6815
(812) 450-6822

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002166A
IN
363AM0700X
Medical Physician Assistant
10002166A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
409570001
MEDICARE ID
IN
Enumeration date
12/01/2016
Last updated
12/17/2018
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