Provider Demographics
NPI:1659329845
Name:LUFT, THOMAS POWELL (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:POWELL
Last Name:LUFT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-358-7750
Mailing Address - Fax:515-358-7751
Practice Address - Street 1:1601 NW 114TH ST
Practice Address - Street 2:STE. 240
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7007
Practice Address - Country:US
Practice Address - Phone:515-358-7750
Practice Address - Fax:515-358-7751
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-03713207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine