Provider Demographics
NPI:1427113182
Name:LEDFORD, JASON CRAIG (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:CRAIG
Last Name:LEDFORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 S PIEDMONT ST
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-2476
Mailing Address - Country:US
Mailing Address - Phone:706-602-9696
Mailing Address - Fax:706-602-8911
Practice Address - Street 1:374 S PIEDMONT ST
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2476
Practice Address - Country:US
Practice Address - Phone:706-602-9696
Practice Address - Fax:706-602-8911
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006555111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFWGMedicare ID - Type Unspecified
GAU78837Medicare UPIN