Deborah A Luetzow
Family Doctor - Adult Medicine
2413 W Rawson Ave
Oak Creek
, Wisconsin 53154-1323
Deborah A Luetzow
Family Doctor - Adult Medicine
2413 W Rawson Ave
Oak Creek
, Wisconsin 53154-1323
(414) 333-0064
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About
Features
Specialties
- Family Doctor - Adult Medicine
Languages spoken
- English
Location
First Address
- Deborah A Luetzow
- 2413 W. Rawson Ave
- Oak Creek, WI
- Zip : 53154
- Phone : (414) 333-0064
Second Address
- Deborah A Luetzow
- 2413 W Rawson Ave
- Oak Creek, WI
- Zip : 53154-1323
- Phone : (414) 333-0064
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QA0505X | Family Doctor - Adult Medicine | 29691 | WI |
National Provider Identifier
| NPI | 1285688713 |
|---|---|
| Provider Name | Deborah A Luetzow |
| First Address | Oak Creek, WI 53154 |
| Second Address | Oak Creek, WI 53154-1323 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/05/2006 |
| Last Update Date | 17/12/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 31555700 | (05) | WI |
| 391703395015 | BLUE CROSS BLUE SHIELD (01) | WI |
| E48369 | (02) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.