Healthcare Provider Details

I. General information

NPI: 1063968352
Provider Name (Legal Business Name): THOMAS LUISKUTTY MD PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7220 S YALE AVE
TULSA OK
74136-6348
US

IV. Provider business mailing address

7134 S YALE AVE STE 500
TULSA OK
74136-6352
US

V. Phone/Fax

Practice location:
  • Phone: 918-392-4763
  • Fax: 702-447-0507
Mailing address:
  • Phone: 918-392-4763
  • Fax: 702-447-0507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS LUISKUTTY
Title or Position: MANAGER
Credential: M.D.
Phone: 918-640-4425