Dr Tomas E Liskutin, MD | |
5316 S Woodrow St Ste 200, Murray, UT 84107-5479 | |
(801) 747-1020 | |
(801) 747-1023 |
Full Name | Dr Tomas E Liskutin |
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Gender | Male |
Speciality | Orthopaedic Surgery - Orthopaedic Trauma |
Location | 5316 S Woodrow St Ste 200, Murray, Utah |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770089005 | NPI | - | NPPES |
200124796 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207XX0801X | Orthopaedic Surgery - Orthopaedic Trauma | 13901333-1205 (Utah) | Primary |
207XX0801X | Orthopaedic Surgery - Orthopaedic Trauma | 2023006696 (Missouri) | Secondary |
Entity Name | Washington University |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679516033 PECOS PAC ID: 9830008770 Enrollment ID: O20040420000704 |
Mailing Address | Practice Location Address |
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Dr Tomas E Liskutin, MD 5316 S Woodrow St Ste 200, Murray, UT 84107-5479 Ph: (801) 747-1020 | Dr Tomas E Liskutin, MD 5316 S Woodrow St Ste 200, Murray, UT 84107-5479 Ph: (801) 747-1020 |
Mitchell Rohrback, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 5316 S Woodrow St Ste 200, Murray, UT 84107 Phone: 801-747-1020 | |
Yvonne Potter Fuellenbach, PA-C Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 5848 Fashion Blvd Ste 110, Murray, UT 84107 Phone: 801-314-4130 Fax: 801-314-4011 | |
Brian W Fukushima, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5316 S Woodrow St Ste 200, Murray, UT 84107 Phone: 801-747-1020 Fax: 801-747-1023 | |
Dr. Christopher Reid West, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5848 S Fashion Blvd Ste 120, Murray, UT 84107 Phone: 801-314-4900 Fax: 801-314-4919 | |
David Christopher Evans, MD Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 5316 S Woodrow St Ste 200, Murray, UT 84107 Phone: 801-747-1020 | |
Stephen Warner, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 5323 South Woodrow Street, Suite 200, Murray, UT 84107 Phone: 801-747-1020 Fax: 801-747-1023 | |
Nathaniel A Ptak, Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 5121 S Cottonwood St, Murray, UT 84107 Phone: 801-507-7000 |