Provider Demographics
NPI:1063476497
Name:LEDFORD, CYNTHIA H (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:H
Last Name:LEDFORD
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 1:660 ACKERMAN RD
Mailing Address - Street 2:PO BOX 183103
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-4500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1609 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-2544
Practice Address - Country:US
Practice Address - Phone:614-293-7980
Practice Address - Fax:614-293-7981
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069785207RA0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2024991Medicaid
G62293Medicare UPIN
OH2024991Medicaid