Provider Demographics
NPI:1124015912
Name:OSTRANDER, JAMIE W (OD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:W
Last Name:OSTRANDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 DUFF AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5469
Mailing Address - Country:US
Mailing Address - Phone:515-239-4400
Mailing Address - Fax:
Practice Address - Street 1:1236 HEIRES AVE
Practice Address - Street 2:
Practice Address - City:CARROLL
Practice Address - State:IA
Practice Address - Zip Code:51401-3328
Practice Address - Country:US
Practice Address - Phone:712-792-3318
Practice Address - Fax:712-792-3319
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02131152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA05321OtherWELLMARK JEFFERSON
IA2184234Medicaid
IA18774OtherWELLMARK IDA GROVE
IA72860OtherCOVENTRY JEFFERSON
IA0184234Medicaid
IA228841OtherMIDLANDS CHOICE
IA73807OtherCOVENTRY CARROLL
IA052237OtherHEALTH ALLIANCE CARROLL
IA056848OtherHEALTH ALLIANCE JEFFERSON
IA1184234Medicaid
IA48241OtherWELLMARK CARROLL
IA48241OtherWELLMARK CARROLL
IA1184234Medicaid
IA05321OtherWELLMARK JEFFERSON
IAU74410Medicare UPIN
IAI17822Medicare PIN
IA72860OtherCOVENTRY JEFFERSON
IAI7563Medicare PIN