Provider Demographics
NPI:1548203292
Name:LEDFORD, CHERYL LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:LYNN
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4646 NORTH MESA STREET
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6104
Mailing Address - Country:US
Mailing Address - Phone:915-313-6300
Mailing Address - Fax:915-521-2028
Practice Address - Street 1:4646 NORTH MESA STREET
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6104
Practice Address - Country:US
Practice Address - Phone:915-313-6300
Practice Address - Fax:915-521-2028
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD44411207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1513124Medicaid
TXTXB153178Medicare PIN
TN1513124Medicaid
TNP00742612Medicare PIN