Provider Demographics
NPI:1851387344
Name:KOSTER, JAMES J (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:KOSTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3330 N 2ND ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2368
Mailing Address - Country:US
Mailing Address - Phone:602-263-9345
Mailing Address - Fax:602-263-0778
Practice Address - Street 1:3330 N 2ND ST
Practice Address - Street 2:SUITE 600
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2368
Practice Address - Country:US
Practice Address - Phone:602-263-9345
Practice Address - Fax:602-263-0778
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ32672207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A20754950OtherBCBS
AZ870643Medicaid
H91627Medicare UPIN
AZ113053Medicare PIN
AZ870643Medicaid
A20754950OtherBCBS