Individual
JACOB K LUDER
Active
Individual
JACOB K LUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2000151553
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11171
COX HEALTH
MO
05
—
158591001
—
AR
01
—
194111
BCBS
MO
05
—
200077430A
—
OK
01
—
20174319965616B003
TRICARE
MO
05
—
204957104
—
MO
05
—
204957120
—
MO
01
—
430998
HEALTHLINK
MO
01
—
P00194821
RAILROAD
MO
Enumeration date
09/14/2005
Last updated
10/28/2022
Update your record
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