Provider Demographics
NPI:1770144263
Name:LEDFORD, PAIGE ALAN
Entity type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:ALAN
Last Name:LEDFORD
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 1:3220 BRECKENRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-3212
Mailing Address - Country:US
Mailing Address - Phone:636-219-2570
Mailing Address - Fax:
Practice Address - Street 1:4123 DUTCHMANS LN STE 515
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4730
Practice Address - Country:US
Practice Address - Phone:502-899-6900
Practice Address - Fax:502-899-6905
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTGC010170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS