Individual
GREGORY JAY KOSTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
600 9TH AVE N, SIBLEY, IA 51249-1012
(712) 754-3658
(712) 754-2634
Mailing address
600 9TH AVE N, #277, SIBLEY, IA 51249-0277
(712) 754-3658
(712) 754-2634
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02096
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10123
PREFERRED ONE
—
01
—
115479
UCARE
MN
01
—
1304516
STATE PHARMACY NUMBER
IA
01
—
21097
SIOX VALLEY HEALTH PLAN
—
05
—
2228510
—
IA
01
—
52254
BLUE SHIELD
IA
01
—
52254
BAAI
—
01
—
539723500
MN MEDICAL ASSISTANCE
MN
05
—
7771982
—
SD
01
—
9D043KO
MN BLUE SHIELD
MN
Enumeration date
01/09/2006
Last updated
03/07/2023
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