Provider Demographics
NPI:1144603184
Name:LEDFORD, KAYLA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 W GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-2414
Mailing Address - Country:US
Mailing Address - Phone:601-613-2514
Mailing Address - Fax:
Practice Address - Street 1:1811 W GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-2414
Practice Address - Country:US
Practice Address - Phone:601-613-2514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-13930183500000X
MS11446031841835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist