Provider Demographics
NPI:1710391198
Name:LUDWIG, RYAN JOHN (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:JOHN
Last Name:LUDWIG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 N DOBSON RD
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6196
Mailing Address - Country:US
Mailing Address - Phone:480-812-0149
Mailing Address - Fax:480-812-9053
Practice Address - Street 1:180 N DOBSON RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6196
Practice Address - Country:US
Practice Address - Phone:480-812-0149
Practice Address - Fax:480-812-9053
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS018228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist