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NPI Code Detail

MEDICARE: DR. JOHN RICHARD LUDTKE MD

MEDICARE: DR. JOHN RICHARD LUDTKE 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
12083A0100XAerospace Medicine PhysicianME127694FL

General Provider Information

NPI Number : 1750305959
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN RICHARD LUDTKE MD
Provider Business Mailing Address
First Line : 2250 LEESTOWN RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40511-1052
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2250 LEESTOWN RD
Second Line :
City : LEXINGTON
State : KY
Zip : 40511-1052
Country : US
Telephone Number : 615-873-6239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 10/27/2023

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