Individual
DR. LARRY D LUETHKE
Active
Individual
DR. LARRY D LUETHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS5001
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518969229
ORGANIZATION NPI
TN
01
—
1609878388
ORGANIZATION NPI
TN
01
—
1972504389
GROUP NPI NUMBER
TN
01
—
3726194
GROUP MEDICARE NUMBER
TN
Enumeration date
08/09/2005
Last updated
01/10/2008
Update your record
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