Provider Demographics
NPI:1033181516
Name:LITZ, THOMAS R (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:R
Last Name:LITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2869 LEECHBURG RD
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-2540
Mailing Address - Country:US
Mailing Address - Phone:724-337-6000
Mailing Address - Fax:724-337-6100
Practice Address - Street 1:2869 LEECHBURG RD
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-2540
Practice Address - Country:US
Practice Address - Phone:724-337-6000
Practice Address - Fax:724-337-6100
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010451L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011181150001Medicaid
PA051856R7RMedicare PIN
PA1011181150001Medicaid