Provider Demographics
NPI:1548367295
Name:TOZER, THOMAS A (DC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:TOZER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W8646 US HIGHWAY 8
Mailing Address - Street 2:
Mailing Address - City:LADYSMITH
Mailing Address - State:WI
Mailing Address - Zip Code:54848-9501
Mailing Address - Country:US
Mailing Address - Phone:715-532-6394
Mailing Address - Fax:
Practice Address - Street 1:W8646 US HIGHWAY 8
Practice Address - Street 2:
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848-9501
Practice Address - Country:US
Practice Address - Phone:715-532-6394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3324-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38890800Medicaid
WI350039649OtherRAILROAD MEDICARE
39923OtherSECURITY HEALTH PLAN
WICB3715OtherRAILROAD MEDICARE GROUP
U59835Medicare UPIN
WI350039649OtherRAILROAD MEDICARE