Individual
MR. KYLE A LUTZ
Active
Individual
MR. KYLE A LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10000720A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000335308
ANTHEM BCBS
—
01
—
100000720
INDIANA STATE LICENSE
IN
05
—
300007791
—
IN
05
—
9500485900
—
KY
Enumeration date
10/11/2006
Last updated
07/24/2026
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