Individual
THOMAS J LISK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1969 W HART RD, BELOIT, WI 53511
(608) 364-5269
Mailing address
340 MIDLAND RD STE 120, JANESVILLE, WI 53546-2339
(086) 743-9313
(608) 743-9318
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
29988020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300034073
RAILROAD MEDICARE
WI
05
—
31481100
—
WI
Enumeration date
07/19/2006
Last updated
07/17/2018
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