Provider Demographics
NPI:1821143926
Name:LEDFORD, SARAH COOK (PA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:COOK
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:200 RIDGE MEDICAL PLAZA RD
Mailing Address - Street 2:
Mailing Address - City:EDGEFIELD
Mailing Address - State:SC
Mailing Address - Zip Code:29824-4530
Mailing Address - Country:US
Mailing Address - Phone:803-637-3146
Mailing Address - Fax:803-637-6597
Practice Address - Street 1:155 RIDGE MEDICAL PLAZA RD
Practice Address - Street 2:SUITE A
Practice Address - City:EDGEFIELD
Practice Address - State:SC
Practice Address - Zip Code:29824
Practice Address - Country:US
Practice Address - Phone:803-637-3146
Practice Address - Fax:803-637-6597
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC678363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical