Provider Demographics
NPI:1376585380
Name:OSTERCAMP, TWYLA D (DO)
Entity Type:Individual
Prefix:
First Name:TWYLA
Middle Name:D
Last Name:OSTERCAMP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 EAST HWY 9
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50436
Mailing Address - Country:US
Mailing Address - Phone:641-585-2904
Mailing Address - Fax:641-585-5417
Practice Address - Street 1:635 EAST HWY 9
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:IA
Practice Address - Zip Code:50436
Practice Address - Country:US
Practice Address - Phone:641-585-2904
Practice Address - Fax:641-428-4997
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44534-021207Q00000X
IA02877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43500100Medicaid
WIF64593Medicare UPIN
WI011000467Medicare ID - Type Unspecified