Provider Demographics
NPI:1154586725
Name:LEDYARD, NORAH B (DO)
Entity type:Individual
Prefix:
First Name:NORAH
Middle Name:B
Last Name:LEDYARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6024 HOOVER RD STE A
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8133
Mailing Address - Country:US
Mailing Address - Phone:614-627-1880
Mailing Address - Fax:
Practice Address - Street 1:6024 HOOVER RD STE A
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8133
Practice Address - Country:US
Practice Address - Phone:614-627-1330
Practice Address - Fax:614-539-4610
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34009630208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2987175Medicaid