Individual
DR. TOMAS E LISKUTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5316 S WOODROW ST STE 200, MURRAY, UT 84107-5479
(801) 747-1020
(801) 747-1023
Mailing address
5316 S WOODROW ST STE 200, MURRAY, UT 84107-5479
(801) 747-1020
(801) 747-1023
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
13901333-1205
UT
207XX0801X
Orthopaedic Trauma Physician
2023006696
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200124796
—
MO
Enumeration date
04/04/2018
Last updated
08/28/2024
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