Individual
JAN OSTERSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
359 - 8TH AVENUE, ASC, SALT LAKE CITY, UT 84103
(801) 408-3200
(801) 733-5618
Mailing address
3340 NORTH CENTER ST, #800, LEHI, UT 84043-7406
(801) 990-1910
(801) 990-1912
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
85-172584-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001563800
—
ID
05
—
002087103
—
NV
01
—
107004823101
IHC
UT
05
—
108839400
—
WY
01
—
14706
PEHP
UT
01
—
1502954
UMWA
UT
01
—
20114
DESERET MUTUAL
UT
01
—
2090168
UNITED HEALTHCARE
UT
01
—
53258
HEALTHY U
UT
05
—
822222
—
AZ
01
—
8597445
WORKERS COMP
UT
01
—
870545614OS1
EDUCATORS MUTUAL
UT
01
—
QM0000075886
ALTIUS
UT
01
—
TPRA07899
MOLINA
UT
Enumeration date
09/01/2006
Last updated
10/15/2012
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