Individual
JOHN L LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 N. SAWYER RD., SUITE B, KENDALLVILLE, IN 46755-2568
(260) 347-8430
(260) 347-8435
Mailing address
1234 E. DUPONT RD., SUITE 3, FORT WAYNE, IN 46825-1545
(260) 373-9728
(260) 458-5664
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
02002752A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000505165
ANTHEM
IN
05
—
2004844950
—
IN
05
—
200484950A
—
IN
01
—
351972384-038
TRICARE
IN
01
—
7450536
AETNA
IN
01
—
9472582
CIGNA
IN
01
—
P00436998
RAILROAD MEDICARE
IN
Enumeration date
05/24/2005
Last updated
09/29/2009
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