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Individual

DR. DAVID J LUDFORD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1921 4TH ST, PERU, IL 61354-3309
(815) 223-0151
(815) 223-0307
Mailing address
1921 4TH ST, PERU, IL 61354-3309
(815) 223-0151
(815) 223-0307

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0284470001
DMERC REGION B
IL
01
05021930
BCBS PROVIDER NUMBER
IL
01
L39591
PIN NUMBER
IL
Enumeration date
12/20/2005
Last updated
07/08/2007
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