Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 054021 | GA |
N | 207PE0004X | Emergency Medical Services | 054021 | GA |
N | 207PP0204X | Pediatric Emergency Physician | 054021 | GA |
N | 207Q00000X | Family Doctor | 054021 | GA |
N | 207QA0505X | Family Doctor - Adult Medicine | 054021 | GA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 054021 | GA |
N | 207QS0010X | Family Doctor - Sports Medicine | 054021 | GA |
NPI | 1033228390 |
---|---|
Provider Name | Dr. John Stanley Oester |
First Address | Augusta, GA 30914-3638 |
Second Address | Augusta, GA 30909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 04/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10062874 | AMERIGROUP (01) | |
1447352778 | NPI - CSRA EMERGENCY PHYS (01) | |
345544 | WELLCARE OF GA (01) | |
52703361002 | BLUE CROSS BLUE SHIELD (01) | GA |
G90822 | (02) | |
T50753 | (05) | SC |