Basic Information
| Provider Information | |||||||||
| NPI: | 1063498061 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUFT | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 860 BETHESDA DR | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437011800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404544651 | ||||||||
| FaxNumber: | 7404544653 | ||||||||
| Practice Location | |||||||||
| Address1: | 751 FOREST AVE STE 202 | ||||||||
| Address2: | |||||||||
| City: | ZANESVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437012875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7404501687 | ||||||||
| FaxNumber: | 7404501693 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2005 | ||||||||
| LastUpdateDate: | 02/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 02/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35077127L | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 000000185149 | 01 | OH | ANTHEM PIN | OTHER | 0408079 | 01 | OH | UHC PIN | OTHER | CA1586 | 01 | GROUP MEDICARE RAILROAD | OTHER | 110205941 | 01 | OH | MEDICARE RAILROAD | OTHER | 0989499 | 01 | OH | GROUP MEDICAID | OTHER | 311413469048 | 01 | OH | CARESOURCE PIN | OTHER | 000000177108 | 01 | OH | UNISON PIN | OTHER |