Lon Lutz, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

30820 Issued in MN

Practice address

7200 Hudson Blvd N
Ste 135
Oakdale, MN 55128-7055

Phone

(651) 313-8250

Fax

(651) 313-8251

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1952352221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S CLIFF AVE",
            "address_2": "STE 106",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571045355",
            "telephone_number": "888-258-0894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 HUDSON BLVD N",
            "address_2": "STE 135",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551287055",
            "telephone_number": "651-313-8250",
            "fax_number": "651-313-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "LON",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MN",
            "license": "30820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952352221",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Oakdale, MN
• Providers in Oakdale, MN by specialty
• Interventional Pain Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.