Individual
CHRISTOPHER LARS JOHNSRUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
411 E CHESTNUT ST # 5A, LOUISVILLE, KY 40202-1713
(502) 588-7450
(502) 588-7728
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
37041
KY
2080P0202X
Pediatric Cardiology Physician
37041
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200114610A
—
IN
05
—
64047947
—
KY
Enumeration date
06/16/2005
Last updated
02/10/2022
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