Healthcare Provider Details
I. General information
NPI: 1245765031
Provider Name (Legal Business Name): COLETTE OESTERLE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/28/2017
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 W IRVINGTON RD # 10
TUCSON AZ
85714-3050
US
IV. Provider business mailing address
839 W CONGRESS ST
TUCSON AZ
85745-2819
US
V. Phone/Fax
- Phone: 520-670-3909
- Fax: 520-309-2560
- Phone: 520-670-3909
- Fax: 520-309-2560
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | R76089 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: