Provider Demographics
NPI:1639101785
Name:LEDBETTER, JOEL C (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:C
Last Name:LEDBETTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 11503
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37401-2503
Mailing Address - Country:US
Mailing Address - Phone:423-778-6501
Mailing Address - Fax:423-778-6837
Practice Address - Street 1:910 BLACKFORD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-1405
Practice Address - Country:US
Practice Address - Phone:423-778-6501
Practice Address - Fax:423-778-6837
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN159322080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF48862Medicare UPIN
TN3011813Medicare ID - Type Unspecified