Provider Demographics
NPI:1942372198
Name:LUDLOW, CHRISTOPHER CLAY (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CLAY
Last Name:LUDLOW
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:PHYSICIAN SUPPORT SERVICES - 2ND FL
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2510 AIRPARK DR
Practice Address - Street 2:SUITE 301
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2449
Practice Address - Country:US
Practice Address - Phone:530-242-3500
Practice Address - Fax:530-242-3546
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2015-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA17530363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP07239Medicare UPIN