Individual
DOUGLAS R LOTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
9800 SHELBYVILLE RD, SUITE #220, LOUISVILLE, KY 40223-2992
(502) 429-8585
(502) 429-6157
Mailing address
9800 SHELBYVILLE RD, SUITE #220, LOUISVILLE, KY 40223-2992
(502) 429-8585
(855) 656-7325
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
01067849A
IN
207K00000X
Allergy & Immunology Physician
Primary
43302
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000655785
ANTHEM PROVIDER NUMBER
KY
05
—
200995040
—
IN
01
—
50028902
PASSPORT
KY
05
—
7100118360
—
KY
Enumeration date
05/18/2007
Last updated
03/16/2021
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