Individual
LARRY W LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
802 E OAK ST, FORT BRANCH, IN 47648-1666
(812) 753-3942
(812) 768-6283
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 753-3942
(812) 768-6283
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027538A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109173
BCBS PIN
IN
05
—
100356750
—
IN
Enumeration date
06/08/2005
Last updated
01/03/2013
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