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Individual

MR. JOHN WILLIAM LEDWITCH III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPNP

Contact information

Practice address
3301 N OAK STREET EXT, VALDOSTA, GA 31605-1014
(229) 242-6061
(229) 242-6151
Mailing address
3301 N OAK STREET EXT, VALDOSTA, GA 31605
(229) 242-6061
(229) 242-6151

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN196360
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
932057257B
GA
05
932057257E
GA
Enumeration date
01/08/2007
Last updated
12/06/2018
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