MEDICARE: JEFFREY L LUTHER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	3790	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4994351	OTHER	SD	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720030521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY L LUTHER MD

Provider Business Mailing Address
First Line	:	5027 S BUR OAK PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2228
Country	:	US
Telephone Number	:	605-271-9000
Fax Number	:	605-275-0502

Provider Business Practice Location Address
First Line	:	5027 S BUR OAK PL
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2228
Country	:	US
Telephone Number	:	605-271-9000
Fax Number	:	605-275-0502

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	02/22/2013

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