Provider Demographics
NPI:1477648889
Name:FOSTER, WILLIAM AUSTIN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:AUSTIN
Last Name:FOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1705
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-0132
Mailing Address - Country:US
Mailing Address - Phone:541-773-7273
Mailing Address - Fax:541-773-2027
Practice Address - Street 1:842 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7134
Practice Address - Country:US
Practice Address - Phone:541-773-7273
Practice Address - Fax:541-773-2027
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR154370207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID003694900Medicaid
AZ828585Medicaid
WY109038100Medicaid
OR500627643Medicaid
ID003694900Medicaid
OR131536Medicare PIN
AZ828585Medicaid