Provider Demographics
NPI:1851384143
Name:LUTHER, GORDON ELLIOT (MD)
Entity type:Individual
Prefix:DR
First Name:GORDON
Middle Name:ELLIOT
Last Name:LUTHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GORDON
Other - Middle Name:ELLIOT
Other - Last Name:HANNIGAN-LUTHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:POST FALLS ER AND HOSPITAL
Mailing Address - Street 2:497 S. BECK RD.
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854
Mailing Address - Country:US
Mailing Address - Phone:208-618-6911
Mailing Address - Fax:
Practice Address - Street 1:WHITMAN HOSPITAL HOSPITAL AND MEDICAL CLINICS
Practice Address - Street 2:1200 W FAIRVIEW ST
Practice Address - City:COLFAX
Practice Address - State:WA
Practice Address - Zip Code:99111
Practice Address - Country:US
Practice Address - Phone:509-397-3435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-7856207P00000X
IDM7856207P00000X
WAMD00030448207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDHBMT8OtherBLUE CROSS
ID805494100Medicaid
IDHBMT8OtherBLUE CROSS
ID1126613Medicare ID - Type UnspecifiedMEDICARE