Provider Demographics
NPI:1821002544
Name:TOZZI, MICHAEL JOHN (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:TOZZI
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:PO BOX 850
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-0850
Mailing Address - Country:US
Mailing Address - Phone:434-447-4736
Mailing Address - Fax:434-447-4810
Practice Address - Street 1:416 BRACEY LN
Practice Address - Street 2:
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1631
Practice Address - Country:US
Practice Address - Phone:434-447-4736
Practice Address - Fax:434-447-4810
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102200839208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007313365Medicaid
VA007313365Medicaid
VAG99408Medicare UPIN