Doctor Name: | DR. MICHAEL RODEN LEDDY |
NPI Number: | 1639145022 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 023179 |
Business Practice Address: | 650 Joel Dr. Blanchfield Army Community Hospital Ft. Campbell, KY - 422235349 |
Business Phone Number: | 2707988400 |
Business Fax Number: | |
Mailing Address: | 650 Joel Dr., Blanchfield Army Community Hospital FT. CAMPBELL |
State: | KY |
Postal Code: | 422235349 |
Phone Number: | 2707988400 |
Fax Number: | |
NPI Enumeration Date: | 02/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VX0000X |
License Number: | 023179 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Obstetrics |
Taxonomy Definition: |