Provider Demographics
NPI:1114259678
Name:LADSON, CATHERINE DORSEY (NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:DORSEY
Last Name:LADSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 HOSPITAL DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-3899
Mailing Address - Country:US
Mailing Address - Phone:478-742-1010
Mailing Address - Fax:478-742-9666
Practice Address - Street 1:330 HOSPITAL DR
Practice Address - Street 2:SUITE 304
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3899
Practice Address - Country:US
Practice Address - Phone:478-742-1010
Practice Address - Fax:478-742-9666
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN192197163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory