Provider Demographics
NPI:1710085196
Name:LEDFORD, MELANIE H (MD)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:H
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 BLAZER PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1887
Mailing Address - Country:US
Mailing Address - Phone:859-264-1815
Mailing Address - Fax:859-264-1820
Practice Address - Street 1:3470 BLAZER PKWY
Practice Address - Street 2:STE 300
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509
Practice Address - Country:US
Practice Address - Phone:859-264-1815
Practice Address - Fax:859-264-1820
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34946208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64078637Medicaid
KY34946OtherKY BOARD OF MEDICAL LICENSURE
KY64078637Medicaid
KYK012462Medicare PIN
KY34946OtherKY BOARD OF MEDICAL LICENSURE
H67151Medicare UPIN
KYK012460Medicare PIN