Provider Demographics
NPI:1447348677
Name:LUTCHE, JOSEPH WILMER (OD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILMER
Last Name:LUTCHE
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:6444 NOLENSVILLE PIKE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4608
Mailing Address - Country:US
Mailing Address - Phone:615-941-7218
Mailing Address - Fax:615-941-7219
Practice Address - Street 1:6444 NOLENSVILLE PIKE
Practice Address - Street 2:SUITE 5
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-4608
Practice Address - Country:US
Practice Address - Phone:615-941-7218
Practice Address - Fax:615-941-7219
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN1830152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN39423721Medicare UPIN