Healthcare Provider Details

I. General information

NPI: 1811996440
Provider Name (Legal Business Name): BARBARA A LUDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 10/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 E 29TH ST NORTH, STE 350 ARTESIAN RADIATION CENTER@CYPRESS
WICHITA KS
67226
US

IV. Provider business mailing address

324 N EMPORIA ST APT 317
WICHITA KS
67202-2547
US

V. Phone/Fax

Practice location:
  • Phone: 316-636-5800
  • Fax: 316-636-5801
Mailing address:
  • Phone: 316-640-0989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number04-22576
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: