Healthcare Provider Details

I. General information

NPI: 1114283066
Provider Name (Legal Business Name): JACOB OSTERBUR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 MONTGOMERY RD DEPT OF HOSPITAL MEDICINE
CINCINNATI OH
45242-4402
US

IV. Provider business mailing address

10500 MONTGOMERY RD DEPT OF HOSPITAL MEDICINE
CINCINNATI OH
45242-4402
US

V. Phone/Fax

Practice location:
  • Phone: 513-865-2246
  • Fax:
Mailing address:
  • Phone: 513-865-2246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34.011120
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number02004932A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number34.011120
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: