Provider Demographics
NPI:1386686582
Name:GOSLIN, JULIUS
Entity Type:Individual
Prefix:
First Name:JULIUS
Middle Name:
Last Name:GOSLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 BUSINESS PARK BLVD BLDG L
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-7167
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4501 BUSINESS PARK BLVD BLDG L
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-7167
Practice Address - Country:US
Practice Address - Phone:907-334-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-012707207Q00000X, 207Q00000X
AKMEDO6546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD0742Medicaid
PA1012051770001Medicaid
PAI25479Medicare UPIN
PA088330Medicare ID - Type Unspecified