Provider Demographics
NPI:1366496473
Name:ENT HEAD & NECK SPECIALISTS PC
Entity Type:Organization
Organization Name:ENT HEAD & NECK SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:K
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-374-5599
Mailing Address - Street 1:985 BERKSHIRE BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1268
Mailing Address - Country:US
Mailing Address - Phone:610-374-5599
Mailing Address - Fax:610-375-1262
Practice Address - Street 1:985 BERKSHIRE BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1268
Practice Address - Country:US
Practice Address - Phone:610-374-5599
Practice Address - Fax:610-375-1262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2023-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty