Individual
JEFFREY S LUTTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10277 BEAVER POND LN, CORNING, NY 14830-9613
(610) 310-1450
Mailing address
10277 BEAVER POND LN, CORNING, NY 14830-9613
(610) 310-1450
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD435658
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007307260034
MEDICAID GROUP #
PA
05
—
102223901 0002
—
PA
01
—
2076567
HIGHMARK BLUE SHIELD
PA
01
—
8147803
AETNA HMO
PA
01
—
867633
MEDICARE GROUP #
PA
01
—
9320302
AETNA NON HMO
PA
01
—
P00964825
RAILROAD MEDICARE
PA
Enumeration date
05/23/2008
Last updated
09/26/2019
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