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NPI Code Detail

MEDICARE: MR. JOSHUA BLAINE OSTLER PA-C

MEDICARE: MR. JOSHUA BLAINE OSTLER PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA1344NV

General Provider Information

NPI Number : 1770740995
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOSHUA BLAINE OSTLER PA-C
Provider Business Mailing Address
First Line : 2809 W CHARLESTON BLVD
Second Line : STE 150
City : LAS VEGAS
State : NV
Zip : 89102-1998
Country : US
Telephone Number : 702-476-9999
Fax Number : 702-946-1343
Provider Business Practice Location Address
First Line : 2809 W CHARLESTON BLVD STE 150
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1998
Country : US
Telephone Number : 702-476-9999
Fax Number : 702-946-1343
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2008
Last Update Date : 08/05/2019

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Directions to “ MR. JOSHUA BLAINE OSTLER PA-C” Practice Location

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