Provider Demographics
NPI:1063498061
Name:LUFT, BRIAN WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:WILLIAM
Last Name:LUFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 BETHESDA DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1800
Mailing Address - Country:US
Mailing Address - Phone:740-454-4651
Mailing Address - Fax:740-454-4653
Practice Address - Street 1:751 FOREST AVE STE 202
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2875
Practice Address - Country:US
Practice Address - Phone:740-450-1687
Practice Address - Fax:740-450-1693
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077127L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000185149OtherANTHEM PIN
OH0408079OtherUHC PIN
CA1586OtherGROUP MEDICARE RAILROAD
OH110205941OtherMEDICARE RAILROAD
OH0989499OtherGROUP MEDICAID
OH311413469048OtherCARESOURCE PIN
OH000000177108OtherUNISON PIN
OH110205941OtherMEDICARE RAILROAD
OH000000185149OtherANTHEM PIN
OH000000177108OtherUNISON PIN
OHLU4017861Medicare ID - Type Unspecified