MEDICARE: DR. JASMINE DIANA USHER LEDET MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35.097655	OH

General Provider Information

NPI Number	:	1376794263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASMINE DIANA USHER LEDET MD

Provider Business Mailing Address
First Line	:	1330 COSHOCTON AVE
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1440
Country	:	US
Telephone Number	:	740-625-6234
Fax Number	:	740-625-5806

Provider Business Practice Location Address
First Line	:	4581 COLUMBUS RD
Second Line	:
City	:	CENTERBURG
State	:	OH
Zip	:	43011-9401
Country	:	US
Telephone Number	:	740-625-6234
Fax Number	:	740-625-5806

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2008
Last Update Date	:	06/24/2022

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