Penton, Lutti

Penton, Lutti is an individual health care provider with primary practice located at 420 E Division St , Fond Du Lac WI 54935-4560. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Penton, Lutti can be contacted via phone (920) 926-8614.

Contact Information

Primary practice address
420 E Division St Fond Du Lac WI 54935-4560
Phone: (920) 926-8614
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 19796 Wisconsin

Profile Details

NPI number 1073595120
LBN Legal business name Penton, Lutti
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073595120 NPPES
Wisconsin MEDICAID 31245800
Wisconsin Other WI01A7
Wisconsin Other 390807236B4
Wisconsin Other 12574

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