Provider Demographics
NPI:1285683888
Name:GUZON, OSLER JAY JUSTO (MD)
Entity Type:Individual
Prefix:
First Name:OSLER JAY
Middle Name:JUSTO
Last Name:GUZON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:111 FRONTENAC FRST
Mailing Address - Street 2:
Mailing Address - City:FRONTENAC
Mailing Address - State:MO
Mailing Address - Zip Code:63131-3259
Mailing Address - Country:US
Mailing Address - Phone:636-931-7101
Mailing Address - Fax:636-933-2383
Practice Address - Street 1:1439 US HWY 61 STE A
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028
Practice Address - Country:US
Practice Address - Phone:636-931-7101
Practice Address - Fax:636-933-2383
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-05-23
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Provider Licenses
StateLicense IDTaxonomies
MO2005013486208M00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0174386Medicaid
MO204403802Medicaid
P00661178OtherRAILROAD MEDICARE