Individual
DOUGLAS S COSLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2455 BACK MOUNTAIN RD, SCOTRUN, PA 18355-7758
(579) 243-8957
(570) 243-8890
Mailing address
18401 VON KARMAN AVE STE 500, IRVINE, CA 92612-8531
(714) 277-3047
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
MD045458L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014098620009
—
PA
Enumeration date
08/31/2005
Last updated
02/05/2024
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