Provider Demographics
NPI:1295775195
Name:OSTER, JOHN GERARD (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GERARD
Last Name:OSTER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2472 PATTERSON RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1285
Mailing Address - Country:US
Mailing Address - Phone:970-424-5555
Mailing Address - Fax:970-424-5027
Practice Address - Street 1:2472 PATTERSON RD
Practice Address - Street 2:SUITE 11
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1285
Practice Address - Country:US
Practice Address - Phone:970-424-5555
Practice Address - Fax:970-424-5027
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2010-04-12
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Provider Licenses
StateLicense IDTaxonomies
CO35363207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01353630Medicaid
COF63097Medicare UPIN
CO01353630Medicaid