Provider Demographics
NPI:1578595096
Name:LUZIER, THOMAS LANGWORTHY (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LANGWORTHY
Last Name:LUZIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S LLOYD ST STE W110
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4512
Mailing Address - Country:US
Mailing Address - Phone:605-225-0025
Mailing Address - Fax:
Practice Address - Street 1:201 S LLOYD ST STE W110
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4512
Practice Address - Country:US
Practice Address - Phone:605-225-0025
Practice Address - Fax:605-225-2259
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDSD1359207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD460422877OtherFEDERAL TAX ID
ND15845Medicaid
SD59-00210Medicaid
SDDQ7592OtherRAILROAD MEDICARE
SD59-00210Medicaid
SD460422877OtherFEDERAL TAX ID
SDD25440Medicare UPIN
ND15845Medicaid