MEDICARE: THOMAS LUISKUTTY MD PLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1063968352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS LUISKUTTY MD PLC

Provider Business Mailing Address
First Line	:	7134 S YALE AVE STE 500
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-6352
Country	:	US
Telephone Number	:	918-392-4763
Fax Number	:

Provider Business Practice Location Address
First Line	:	7220 S YALE AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-6348
Country	:	US
Telephone Number	:	918-392-4763
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. THOMAS LUISKUTTY
Credential	:	M.D.
Telephone Number	:	918-640-4425

Provider Enumeration Date	:	08/28/2016
Last Update Date	:	06/09/2026

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