Provider Demographics
NPI:1750546859
Name:DOUGLAS TOZZOLI, DPM, PC
Entity type:Organization
Organization Name:DOUGLAS TOZZOLI, DPM, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:TOZZOLI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:505-988-8863
Mailing Address - Street 1:539 HARKLE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4782
Mailing Address - Country:US
Mailing Address - Phone:505-988-8863
Mailing Address - Fax:505-988-5940
Practice Address - Street 1:539 HARKLE RD
Practice Address - Street 2:SUITE C
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4782
Practice Address - Country:US
Practice Address - Phone:505-988-8863
Practice Address - Fax:505-988-5940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM302213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty