Healthcare Provider Details

I. General information

NPI: 1669411195
Provider Name (Legal Business Name): LUTHER K ARNOLD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 LINCOLN ST
LEXINGTON MA
02421-6805
US

IV. Provider business mailing address

45 LINCOLN ST
LEXINGTON MA
02421-6805
US

V. Phone/Fax

Practice location:
  • Phone: 781-860-0234
  • Fax:
Mailing address:
  • Phone: 781-860-0234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number51816
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: