Provider Demographics
NPI:1619086634
Name:LADD, BYRON SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:BYRON
Middle Name:SCOTT
Last Name:LADD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 WESTHAMPTON STA
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3330
Mailing Address - Country:US
Mailing Address - Phone:804-287-4200
Mailing Address - Fax:
Practice Address - Street 1:7301 FOREST AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3792
Practice Address - Country:US
Practice Address - Phone:804-285-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232577207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
55419OtherOPTIMA
VA006303102Medicaid
287731OtherANTHEM
220584OtherMDIPA
2809337OtherAETNA
169099OtherSOUTHERN HEALTH
0801032OtherUHC
28187OtherCIGNA
28187OtherCIGNA
287731OtherANTHEM