Provider Demographics
NPI:1538175450
Name:LEDFORD, LORA A (OD)
Entity type:Individual
Prefix:DR
First Name:LORA
Middle Name:A
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10051 A SIMONSON ROAD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030
Mailing Address - Country:US
Mailing Address - Phone:513-367-4262
Mailing Address - Fax:513-367-1643
Practice Address - Street 1:10051 A SIMONSON ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030
Practice Address - Country:US
Practice Address - Phone:513-367-4262
Practice Address - Fax:513-367-1643
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5220152W00000X
KY1515DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4054881Medicare ID - Type Unspecified
U85732Medicare UPIN