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General NPI Number Information
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NPI Number | 1437123080
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Entity Type | Individual
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Provider Name | WILLIAM B LUTES D.O.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 7401 104TH AVE STE 110
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City | KENOSHA
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State | WI
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Zip | 53142-7845
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Country | US
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Telephone | 262-764-5595
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Fax | 262-764-9314
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Provider Business Mailing Address
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Address Line | 7401 104TH AVE STE 110
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City | KENOSHA
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State | WI
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Zip | 53142-7845
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Country | US
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Telephone | 262-764-5595
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Fax | 262-764-9314
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 52122-021
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 52122-021
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License Number State | WI
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