Individual
CHARLES JOSEPH LUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 632-5000
Mailing address
PO BOX 633819, CINCINNATI, OH 45263-0001
(865) 292-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R4C41
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241703743
—
MO
01
—
P00322455
RAILROAD MEDICARE
MO
Enumeration date
06/09/2006
Last updated
09/15/2022
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