Individual
JOHN F KLUDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
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
Update your record
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