Organization
OHIO VASCULAR SURGERY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH STEPHEN LUTTER MD (OWNER)
(614) 457-5191
Entity
Organization
Contact information
Practice address
941 CHATHAM LANE, SUITE 215, COLUMBUS, OH 43221-2416
(614) 457-5191
(614) 459-6874
Mailing address
941 CHATHAM LANE, SUITE 215, COLUMBUS, OH 43221-2416
(614) 457-5191
(614) 459-6874
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2005627
—
OH
01
—
CD5306
RR MEDICARE
OH
Enumeration date
02/12/2007
Last updated
04/25/2019
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