Provider Demographics
NPI:1932178373
Name:LADU, KEITH ALAN (DO)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:ALAN
Last Name:LADU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 S CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1397
Mailing Address - Country:US
Mailing Address - Phone:614-890-6555
Mailing Address - Fax:614-823-8881
Practice Address - Street 1:6785 BOBCAT WAY STE 300
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-1443
Practice Address - Country:US
Practice Address - Phone:614-890-6555
Practice Address - Fax:614-823-8881
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005826207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
200034131OtherRAILROAD MEDICARE
OH2024893Medicaid
310846816KELOtherSUMMIT
7611083004OtherCIGNA
000000198267OtherANTHEM
0005552679OtherAETNA
20984OtherNATIONWIDE
000000226359OtherANTHEM
310846816006OtherPRUDENTIAL
0901173OtherUNITED HEALTHCARE
OH9372391OtherMEDICARE PTAN
000000226359OtherANTHEM
20984OtherNATIONWIDE
0005552679OtherAETNA
G62769Medicare UPIN
LA0832174Medicare ID - Type Unspecified