Individual
DR. CONNOR DANIEL LUDOVISSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-5000
(731) 660-8739
Mailing address
620 SKYLINE DR, JACKSON, TN 38301-3923
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
TP989
KY
207Q00000X
Family Medicine Physician
Primary
05346
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2018
Last updated
09/22/2025
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