Healthcare Provider Details

I. General information

NPI: 1891323614
Provider Name (Legal Business Name): JOSIAH JAMES TOUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7061 GRAND MONTECITO PKWY
LAS VEGAS NV
89149-0287
US

IV. Provider business mailing address

PO BOX 35380
LAS VEGAS NV
89133-5380
US

V. Phone/Fax

Practice location:
  • Phone: 270-651-4865
  • Fax:
Mailing address:
  • Phone: 702-838-8265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number24372
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: