Provider Demographics
NPI:1437404761
Name:GAST, JOSH D (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSH
Middle Name:D
Last Name:GAST
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:335 HIDDEN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-3274
Mailing Address - Country:US
Mailing Address - Phone:573-986-8923
Mailing Address - Fax:
Practice Address - Street 1:304 S MOUNT AUBURN RD
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-4920
Practice Address - Country:US
Practice Address - Phone:573-803-2941
Practice Address - Fax:573-803-0815
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2020-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY03680208M00000X
MO2011018182207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1437404761OtherCOMMERCIAL