Individual
DR. JON E LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811
Mailing address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6051
(541) 382-2811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G53950
CA
207RI0200X
Infectious Disease Physician
G53950
CA
207RI0200X
Infectious Disease Physician
Primary
MD29015
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00834442
MEDICARE RAILROAD
OR
05
—
500605415
—
OR
05
—
770460211
—
CA
Enumeration date
09/14/2006
Last updated
04/12/2013
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