Eduardo T Tolosa MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

0101022191 Issued in VA

Legal business name

EDUARDO T TOLOSA MD PC

Practice address

984 Ben Bolt Ave
Tazewell, VA 24651-9706

Phone

(276) 988-6559

Fax

(276) 988-6550

NPI assigned

Jan 26, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eduardo T Tolosa, MD

Title

PC President

Phone

(276) 988-6559

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285286400000",
    "number": "1871824136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 BEN BOLT AVE",
            "address_2": "P.O. BOX 837",
            "city": "TAZEWELL",
            "state": "VA",
            "postal_code": "246519706",
            "telephone_number": "276-988-6559",
            "fax_number": "276-988-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 BEN BOLT AVE",
            "city": "TAZEWELL",
            "state": "VA",
            "postal_code": "246519706",
            "telephone_number": "276-988-6559",
            "fax_number": "276-988-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUARDO T TOLOSA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-09-24",
        "status": "A",
        "authorized_official_last_name": "TOLOSA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PC PRESIDENT",
        "authorized_official_telephone_number": "276-988-6559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101022191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720008485",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Tazewell, VA
• Primary Care Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.