Provider Demographics
NPI:1740268093
Name:LUTER, DENNIS W (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:W
Last Name:LUTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1117 MCLAIN ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-3500
Mailing Address - Country:US
Mailing Address - Phone:870-523-9100
Mailing Address - Fax:870-523-9107
Practice Address - Street 1:1117 MCLAIN ST
Practice Address - Street 2:SUITE 500
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3500
Practice Address - Country:US
Practice Address - Phone:870-523-9100
Practice Address - Fax:870-523-9107
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5215174400000X
ARC-5215207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR53247C207OtherMEDICARE
AR105427001Medicaid
AR53247C207OtherMEDICARE
ARP00243302Medicare PIN
ARB90402Medicare UPIN