Provider Demographics
NPI:1487842787
Name:DERON LUDWIG, M.D., INC
Entity Type:Organization
Organization Name:DERON LUDWIG, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DERON
Authorized Official - Middle Name:
Authorized Official - Last Name:LUDWIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-891-1651
Mailing Address - Street 1:251 COHASSET RD STE 310
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-2239
Mailing Address - Country:US
Mailing Address - Phone:530-891-1651
Mailing Address - Fax:
Practice Address - Street 1:251 COHASSET RD STE 310
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2274
Practice Address - Country:US
Practice Address - Phone:530-891-1651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03850ZMedicare PIN
CAH62802Medicare UPIN