Individual
HOLLY KRISTINE LEDYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
175 N MEDICAL DR E, RM 3100, SALT LAKE CITY, UT 84132-0001
(801) 587-9953
(801) 587-8039
Mailing address
175 N MEDICAL DR E, RM 3100, SALT LAKE CITY, UT 84132-0001
(801) 587-9953
(801) 587-8039
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35.087845
OH
207P00000X
Emergency Medicine Physician
Primary
7009281-1205
UT
2084N0400X
Neurology Physician
7009281-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35.087845
OHIO MEDICAL LICENSE
OH
01
—
7009281-1205
UTAH LICENSE
UT
Enumeration date
08/29/2006
Last updated
11/18/2021
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