Provider Demographics
NPI:1396827101
Name:LUDWIG, JASON A (OD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:A
Last Name:LUDWIG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6518 ROUTE 22 STE 456
Mailing Address - Street 2:
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-2410
Mailing Address - Country:US
Mailing Address - Phone:724-468-8877
Mailing Address - Fax:724-468-0029
Practice Address - Street 1:6518 ROUTE 22 STE 456
Practice Address - Street 2:
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626-2410
Practice Address - Country:US
Practice Address - Phone:724-468-8877
Practice Address - Fax:724-468-0029
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001490152W00000X
PAOEG002585152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist