Individual
MR. JAY I TISCHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1080 FIRST COLONIAL RD, STE 400, VIRGINIA BEACH, VA 23454-2406
(757) 395-1880
(757) 431-7770
Mailing address
1080 FIRST COLONIAL RD, STE 400, VIRGINIA BEACH, VA 23454-2406
(757) 395-1880
(757) 431-7770
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0103000360
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011560
ANTHEM PROVIDER NUMBER
VA
01
—
15423
OPTIMA PROVIDER NUMBER
VA
01
—
311651
MDIPA MAMSI PROVIDER NUMB
VA
05
—
9301071
—
VA
Enumeration date
08/24/2005
Last updated
09/15/2014
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