Provider Demographics
NPI:1932239563
Name:TOZER, RANDALL KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:KEITH
Last Name:TOZER
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 1:9811 N 95TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4527
Mailing Address - Country:US
Mailing Address - Phone:480-947-4493
Mailing Address - Fax:480-947-4751
Practice Address - Street 1:9811 N 95TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4527
Practice Address - Country:US
Practice Address - Phone:480-947-4493
Practice Address - Fax:480-947-4751
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15045207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ18003310OtherMEDICARE RAILROAD
AZAZ0181120OtherBCBS PIN
AZZ0000BGMRTMedicare PIN
D44588Medicare UPIN
AZ18003310OtherMEDICARE RAILROAD
Z137332Medicare PIN