Individual
DR. KEVIN WILLIAM LUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
720 E BROAD ST, SUITE 100, COLUMBUS, OH 43215-3988
(614) 461-6634
(614) 461-7136
Mailing address
720 E BROAD ST, SUITE 100, COLUMBUS, OH 43215-3988
(614) 461-6634
(614) 461-7136
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
36003275
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11108332
CAQH
OH
05
—
2458648
—
OH
Enumeration date
09/23/2005
Last updated
12/23/2011
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