Individual
DR. CHARLES M. LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T03108
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108615
BLUE CROSS BLUE SHIELD MO
—
01
—
110972
EYEMED
—
01
—
20264
HEALTHCARE USA
MO
01
—
20990
OPTICARE MED. COMPLETE
—
01
—
22-01201
UNITED HEALTHCARE
—
05
—
314895202
—
MO
05
—
314895210
—
MO
01
—
410048087
RR MEDICARE
IL
01
—
44325
DAVIS VISION
—
01
—
675482
HEALTHLINK
—
01
—
P00403026
RR MEDICARE
MO
01
—
U90217
MERCY HEALTH PLANS
—
01
—
UNKNOWN
GROUP HEALTH PLAN
—
Enumeration date
03/20/2006
Last updated
12/19/2012
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