Provider Demographics
NPI:1235524802
Name:OSTLER, JOSEPH ELDON (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ELDON
Last Name:OSTLER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 CANYON CREST DR
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3007
Mailing Address - Country:US
Mailing Address - Phone:208-814-7100
Mailing Address - Fax:208-814-7138
Practice Address - Street 1:1840 CANYON CREST DR
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3007
Practice Address - Country:US
Practice Address - Phone:208-814-7100
Practice Address - Fax:208-814-7138
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-17252208100000X
AZ59363208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty