Provider Demographics
NPI:1811922560
Name:LUDWIG, LEE V (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:V
Last Name:LUDWIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 CARONDELEET DR
Mailing Address - Street 2:PROVIDER ENROLLMENT/MED STAFF OFC
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114
Mailing Address - Country:US
Mailing Address - Phone:816-943-5744
Mailing Address - Fax:
Practice Address - Street 1:8919 PARALLEL PKWY
Practice Address - Street 2:SUITE 206
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1636
Practice Address - Country:US
Practice Address - Phone:913-334-6800
Practice Address - Fax:913-334-0875
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0419835208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSD93567Medicare UPIN
KS100128350BMedicaid
KS0003138Medicare PIN