Healthcare Provider Details

I. General information

NPI: 1861464703
Provider Name (Legal Business Name): CHRISTOPHER T LUDLOW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2006
Last Update Date: 09/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 SHAWNEE ST
SAVANNAH GA
31419-1618
US

IV. Provider business mailing address

518 STUART CT
SAVANNAH GA
31405-5460
US

V. Phone/Fax

Practice location:
  • Phone: 912-920-0214
  • Fax: 912-921-2004
Mailing address:
  • Phone: 912-920-0214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number030501
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: