Healthcare Provider Details

I. General information

NPI: 1932178373
Provider Name (Legal Business Name): KEITH ALAN LADU DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6785 BOBCAT WAY STE 300
DUBLIN OH
43016-1443
US

IV. Provider business mailing address

70 S CLEVELAND AVE
WESTERVILLE OH
43081-1397
US

V. Phone/Fax

Practice location:
  • Phone: 614-890-6555
  • Fax: 614-823-8881
Mailing address:
  • Phone: 614-890-6555
  • Fax: 614-823-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number34005826
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: