Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 40892 | TN |
Y | 207RI0011X | Interventional Cardiology | 40892 | TN |
NPI | 1033180971 |
---|---|
Provider Name | Dr. Calvin Samuel Ledford |
First Address | Chattanooga, TN 37404-1127 |
Second Address | Chattanooga, TN 37404-1127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 12/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1506235 | (05) | TN |