Provider Demographics
NPI:1972562064
Name:LEDBETTER, BUFORD BROWN JR (MD)
Entity Type:Individual
Prefix:MR
First Name:BUFORD
Middle Name:BROWN
Last Name:LEDBETTER
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:331 LANDRUM PL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6329
Mailing Address - Country:US
Mailing Address - Phone:931-645-4200
Mailing Address - Fax:931-645-4285
Practice Address - Street 1:1731 MEMORIAL DRIVE
Practice Address - Street 2:SUITE 203
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043
Practice Address - Country:US
Practice Address - Phone:931-645-4200
Practice Address - Fax:931-645-4285
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2016-04-07
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Provider Licenses
StateLicense IDTaxonomies
TNMD9047207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3172834Medicare PIN
C46982Medicare UPIN