Individual
DR. CHARLES M. LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1944 ZUMBEHL RD, SAINT CHARLES, MO 63303-2721
(636) 916-5367
(800) 432-6004
Mailing address
211 E BROADWAY, ALTON, IL 62002-6220
(636) 916-5367
(800) 432-6004
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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