Provider Demographics
NPI:1497884480
Name:MARTIN J. LUFTMAN, M.D. PSC
Entity Type:Organization
Organization Name:MARTIN J. LUFTMAN, M.D. PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LUFTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-278-8504
Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:B-360
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:859-278-8504
Mailing Address - Fax:859-276-5500
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:B-360
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3751
Practice Address - Country:US
Practice Address - Phone:859-278-8504
Practice Address - Fax:859-276-5500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21366208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC74580Medicare UPIN
KY1355401Medicare ID - Type Unspecified