Provider Demographics
NPI:1225048325
Name:FOSTER, WILLIAM FRANK (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANK
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2847
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97339-2847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 9TH ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-7398
Practice Address - Country:US
Practice Address - Phone:541-997-8412
Practice Address - Fax:541-997-9650
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219027207P00000X
CAG77147207P00000X
ORMD28521207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G771470Medicaid
OR246619Medicaid
CAG77147OtherMD LICENSE
NY219027OtherMD LICENSE
CA00G771470Medicaid
CA00G771477Medicare PIN
CAAR957ZMedicare PIN
ORR142901Medicare PIN
CAG77147OtherMD LICENSE
CA00G771476Medicare PIN