| Dr Keith Roger Lutter, DO | |
|
620 Nw 11th St Ste M106, Hermiston, OR 97838-6941 | |
| (541) 667-3801 | |
| (541) 667-3802 |
| Full Name | Dr Keith Roger Lutter |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 620 Nw 11th St Ste M106, Hermiston, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447487327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | R1698 (Arizona) | Secondary |
| 207V00000X | Obstetrics & Gynecology | DO179344 (Oregon) | Primary |
| Entity Name | Tuba City Regional Health Care Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548294424 PECOS PAC ID: 4284542531 Enrollment ID: O20031105000107 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Keith Roger Lutter, DO 620 Nw 11th St Ste M201, Hermiston, OR 97838-6941 Ph: (541) 289-4118 | Dr Keith Roger Lutter, DO 620 Nw 11th St Ste M106, Hermiston, OR 97838-6941 Ph: (541) 667-3801 |
Diana L Edenfield, MD Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 620 Nw 11th St Ste M106, Hermiston, OR 97838 Phone: 541-667-3801 Fax: 541-667-3802 | |
Dr. Allison Vera Khavkin, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 620 Nw 11th St Ste M106, Hermiston, OR 97838 Phone: 541-667-3801 Fax: 541-667-3802 | |
Dr. Kendal T. Snider, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 620 Nw 11th St Ste M106, Hermiston, OR 97838 Phone: 541-667-3801 Fax: 541-667-3802 | |
Gary J Trupp, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 620 Nw 11th St Ste M106, Hermiston, OR 97838 Phone: 541-667-3801 Fax: 541-667-3802 |