Provider Demographics
NPI:1649660747
Name:FOSTER, JOHN A (EMT-P)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:A
Last Name:FOSTER
Suffix:
Gender:M
Credentials:EMT-P
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EMT-P
Mailing Address - Street 1:3421 HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-5009
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3421 HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-5009
Practice Address - Country:US
Practice Address - Phone:850-819-1795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-27
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMD-525661146L00000X
AL1300433146L00000X
IN8021-1846146L00000X, 146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPMD-525661OtherPARAMEDIC LICENSE
IN0821-1846OtherEMEGENCY MEDICAL TECHNICIAN LICENSE
AL1300433OtherPARAMEDIC LICENSE
FLPMD-525661OtherPARAMEDIC LICENSE
M5008366OtherNATIONAL REGISTRY OF EMERGENCY MEDICAL TECHNICIANS