1689724668 NPI number — MR. PHILIP BERNARD OSSOWSKI PA

Table of content: MR. PHILIP BERNARD OSSOWSKI PA (NPI 1689724668)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689724668 NPI number — MR. PHILIP BERNARD OSSOWSKI PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSSOWSKI
Provider First Name:
PHILIP
Provider Middle Name:
BERNARD
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689724668
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
124 WICKIUP TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARKER HEIGHTS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76548-2051
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-702-6669
Provider Business Mailing Address Fax Number:
254-288-8114

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36000 DARNALL LOOP
Provider Second Line Business Practice Location Address:
CARL R. DARNALL ARMY MEDICAL CENTER
Provider Business Practice Location Address City Name:
FT HOOD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-288-8114
Provider Business Practice Location Address Fax Number:
254-618-8099
Provider Enumeration Date:
01/11/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com