Individual
DENISE M LEDOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
55 WHITCHER ST NE, SUITE 350, MARIETTA, GA 30060-1155
(770) 424-6893
(678) 819-0357
Mailing address
55 WHITCHER ST NE, SUITE 350, MARIETTA, GA 30060-1155
(770) 424-6893
(678) 819-0357
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001927
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109728A
—
GA
05
—
003109728B
—
GA
05
—
003109728C
—
GA
Enumeration date
01/25/2007
Last updated
06/27/2012
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