Individual
JOHN F KLUDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1000 HIGHWAY 12, HETTINGER, ND 58639
(701) 567-6133
Mailing address
1100 HIGHWAY 12, HETTINGER, ND 58639-7533
(701) 567-6130
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0504
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11201
ND BC/BS
—
05
—
480545
—
MT
05
—
60435
—
ND
01
—
800504
ND BC VISION
—
05
—
9202430
—
SD
Enumeration date
10/02/2006
Last updated
07/08/2007
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