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General NPI Number Information
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NPI Number | 1831273218
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Entity Type | Organization
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Legal Business Name | C WILLIAM LUTTON MD PC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 05/24/2012
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Provider Practice Location Address
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Address Line | 333 S 38TH ST SUITE H
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City | MUSKOGEE
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State | OK
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Zip | 74401-4937
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Country | US
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Telephone | 918-683-3702
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Fax | 918-683-3683
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Provider Business Mailing Address
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Address Line | 333 S 38TH ST SUITE H
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City | MUSKOGEE
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State | OK
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Zip | 74401-4937
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Country | US
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Telephone | 918-683-3702
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Fax | 918-683-3683
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES WILLIAM LUTTON
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Credential | M.D.
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Telephone | 918-683-3702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 18384
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License Number State | OK
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