Healthcare Provider Details

I. General information

NPI: 1902863541
Provider Name (Legal Business Name): HEIDI JO OSTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI JO JATANA M.D.

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 11/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10099 RIDGE GATE PARKWAY, SUITE 280
LONE TREE CO
80124
US

IV. Provider business mailing address

10099 RIDGE GATE PARKWAY, SUITE 280
LONE TREE CO
80124
US

V. Phone/Fax

Practice location:
  • Phone: 303-791-2112
  • Fax: 303-683-6415
Mailing address:
  • Phone: 303-791-2112
  • Fax: 303-683-6415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number37061
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: