MEDICARE: JON OSTROWSKI M.D. P.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
1	261QM2500X	Medical Specialty Clinic/Center	19380	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730424854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JON OSTROWSKI M.D. P.C.

Provider Business Mailing Address
First Line	:	2260 N ROSEMONT BLVD
Second Line	:	SUITE 104
City	:	TUCSON
State	:	AZ
Zip	:	85712-2137
Country	:	US
Telephone Number	:	520-795-8510
Fax Number	:	520-795-9214

Provider Business Practice Location Address
First Line	:	2260 N ROSEMONT BLVD
Second Line	:	SUITE 104
City	:	TUCSON
State	:	AZ
Zip	:	85712-2137
Country	:	US
Telephone Number	:	520-795-8510
Fax Number	:	520-795-9214

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. JON ALAN OSTROWSKI
Credential	:	M.D.
Telephone Number	:	520-795-8510

Provider Enumeration Date	:	11/29/2012
Last Update Date	:	11/29/2012

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