Basic Information
Provider Information
NPI: 1427463033
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OSTLER
FirstName: PETER
MiddleName: E
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 502 E MONROE ST
Address2:  
City: RAPID CITY
State: SD
PostalCode: 577011400
CountryCode: US
TelephoneNumber: 6057554060
FaxNumber: 6057554015
Practice Location
Address1: 502 E MONROE ST
Address2:  
City: RAPID CITY
State: SD
PostalCode: 577011400
CountryCode: US
TelephoneNumber: 6057554060
FaxNumber: 6057554012
Other Information
ProviderEnumerationDate: 06/23/2014
LastUpdateDate: 08/07/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X10430SDY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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