Provider Demographics
NPI:1689770398
Name:LUDWIG, GREGG ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:ALAN
Last Name:LUDWIG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2901 MAIN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4242
Mailing Address - Country:US
Mailing Address - Phone:970-259-3838
Mailing Address - Fax:970-247-3074
Practice Address - Street 1:2901 MAIN AVE STE B
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4554
Practice Address - Country:US
Practice Address - Phone:970-259-3838
Practice Address - Fax:970-247-3074
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO344213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist