Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01058980A | IN |
N | 111NI0900X | Internist | 01058980A | IN |
N | 207RC0200X | Critical Care Medicine | 01058980A | IN |
N | 207RC0200X | Critical Care Medicine | 4301076107 | MI |
N | 207RP1001X | Pulmonary Disease | 01058980A | IN |
Y | 207RP1001X | Pulmonary Disease | 4301076107 | MI |
NPI | 1073705935 |
---|---|
Provider Name | Dr. Jason R Ladwig |
First Address | Kalamazoo, MI 49048-1650 |
Second Address | Kalamazoo, MI 49048-1650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2007 |
Last Update Date | 02/05/2016 |