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Individual

CHRISTOPHER K LEDBETTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6555 QUINCE RD, MEMPHIS, TN 38119-8202
(901) 515-5704
(901) 515-5729
Mailing address
877 JEFFERSON AVE, ATTN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103-2807

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
44939
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07150821
MS
05
177760001
AR
01
4355605
BCBS
TN
01
P01288704
RAILROAD MEDICARE
TN
05
Q002444
TN
Enumeration date
05/30/2007
Last updated
01/24/2018
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