Healthcare Provider Details

I. General information

NPI: 1497884480
Provider Name (Legal Business Name): MARTIN J. LUFTMAN, M.D. PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 HARRODSBURG RD B-360
LEXINGTON KY
40504-3751
US

IV. Provider business mailing address

1401 HARRODSBURG RD B-360
LEXINGTON KY
40504-3751
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-8504
  • Fax: 859-276-5500
Mailing address:
  • Phone: 859-278-8504
  • Fax: 859-276-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number21366
License Number StateKY

VIII. Authorized Official

Name: MARTIN J LUFTMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 859-278-8504