Provider Demographics
NPI:1134759319
Name:LADSON, CAREY
Entity type:Individual
Prefix:
First Name:CAREY
Middle Name:
Last Name:LADSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:669 RED CLAY RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-6515
Mailing Address - Country:US
Mailing Address - Phone:912-501-4079
Mailing Address - Fax:
Practice Address - Street 1:2449 THOMAS DAVIS RD
Practice Address - Street 2:
Practice Address - City:AXSON
Practice Address - State:GA
Practice Address - Zip Code:31624-6344
Practice Address - Country:US
Practice Address - Phone:912-422-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider