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Individual
DR. JAY ALLEN LUGTHART
Active
Individual
DR. JAY ALLEN LUGTHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
JL039848
MI
207QG0300X
Geriatric Medicine (Family Medicine) Physician
JL039848
MI
208D00000X
General Practice Physician
Primary
JL039848
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107011492
BCBS
—
01
—
114151PC
CCPPO, CHMO, MERCY HEALTH
—
01
—
121787
HEALR
—
01
—
152756
PHCS
—
01
—
4099325
AETNA
—
01
—
B44069
PRIORITY HEALTH
MI
Enumeration date
04/03/2007
Last updated
04/01/2008
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