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General NPI Number Information
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NPI Number | 1639168479
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Entity Type | Individual
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Provider Name | MARK JAMES FOSTER PA
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Gender | Male
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1942 E MAIN ST
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City | CORTEZ
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State | CO
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Zip | 81321-3039
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Country | US
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Telephone | 970-516-5500
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Fax | 970-516-2500
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Provider Business Mailing Address
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Address Line | 2577 MAIN AVE
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City | DURANGO
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State | CO
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Zip | 81301-5919
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Country | US
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Telephone | 970-247-8382
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Fax | 970-259-4403
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1467
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License Number State |
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