Provider Demographics
NPI:1114288610
Name:TOZER, JORDAN TRAVIS (MD)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:TRAVIS
Last Name:TOZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 980401
Mailing Address - Street 2:EM: EMERGENCY MEDICINE
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0401
Mailing Address - Country:US
Mailing Address - Phone:804-828-4860
Mailing Address - Fax:804-828-4603
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:EM: EMERGENCY MEDICINE
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-828-4860
Practice Address - Fax:804-828-4603
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101258167207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine