Organization
LAKE COUNTRY SURGICAL, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL JOHN TOZZI D.O. (PRESIDENT / OWNER)
(434) 447-4736
Entity
Organization
Contact information
Practice address
416 BRACEY LN, SOUTH HILL, VA 23970-1631
(434) 447-4736
(434) 447-4810
Mailing address
PO BOX 850, SOUTH HILL, VA 23970-0850
(434) 447-4736
(434) 447-4810
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0102200839
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007313365
—
VA
Enumeration date
07/28/2006
Last updated
06/17/2009
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