Individual
DR. JONATHAN P LUDLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
10730A ENDURING FREEDOM DR STE A, FORT DRUM, NY 13602-5405
(315) 405-8671
(315) 773-1820
Mailing address
10730A ENDURING FREEDOM DR, FORT DRUM, NY 13602-5405
(315) 405-8671
(315) 971-4633
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV0061121
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02008780
—
NY
01
—
410043899
RRMCR
NY
01
—
52833A
MEDICARE PTAN
NY
01
—
G0185822450
BNY
NY
01
—
TUV006112
NEW YORK STATE
NY
Enumeration date
11/15/2005
Last updated
11/29/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us