Provider Demographics
NPI:1174572747
Name:OZTAS, OZGUR (MD)
Entity type:Individual
Prefix:DR
First Name:OZGUR
Middle Name:
Last Name:OZTAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3280 DAUPHIN ST BLDG A
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-4060
Mailing Address - Country:US
Mailing Address - Phone:251-450-3700
Mailing Address - Fax:251-450-4492
Practice Address - Street 1:3280 DAUPHIN ST BLDG A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-4060
Practice Address - Country:US
Practice Address - Phone:251-450-3700
Practice Address - Fax:251-450-4492
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251722084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051553752Medicaid
AL51593021OtherBCBS - 3401 MEDICAL PARK DR
AL51593020OtherBCBS - STANTON RD
AL051553752Medicaid
AL051538331Medicare PIN
AL510I130022Medicare PIN
051553752Medicare ID - Type Unspecified