MEDICARE: LUDWIG J ASZOD PA

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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1104586312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUDWIG J ASZOD PA

Provider Business Mailing Address
First Line	:	3012 WEST MAIN STREET
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-8007
Country	:	US
Telephone Number	:	479-774-2131
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 S ROGERS ST
Second Line	:	STE C
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-4331
Country	:	US
Telephone Number	:	479-335-5747
Fax Number	:	479-957-9083

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LUDWIG J ASZOD
Credential	:	LPC
Telephone Number	:	479-774-2131

Provider Enumeration Date	:	12/29/2021
Last Update Date	:	01/06/2022

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