Healthcare Provider Details

I. General information

NPI: 1891751665
Provider Name (Legal Business Name): WILLIAM WYATT LEDKINS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6880 US HIGHWAY 90 STE 10
DAPHNE AL
36526-9522
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 251-210-2901
  • Fax:
Mailing address:
  • Phone: 816-492-2367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH12281
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number25176
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: