Provider Demographics
NPI:1316181464
Name:TEDFORD, MILANA KLIGMAN (MD)
Entity Type:Individual
Prefix:
First Name:MILANA
Middle Name:KLIGMAN
Last Name:TEDFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MILANA
Other - Middle Name:
Other - Last Name:KLIGMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4300 WEST 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7199
Mailing Address - Country:US
Mailing Address - Phone:501-257-5105
Mailing Address - Fax:
Practice Address - Street 1:4300 WEST 7TH STREET
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7199
Practice Address - Country:US
Practice Address - Phone:501-257-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
ARE-7406207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program