Provider Demographics
NPI:1124017942
Name:COSGROVE, PATRICIA A (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:A
Last Name:COSGROVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3820 N. 27TH AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718
Mailing Address - Country:US
Mailing Address - Phone:406-587-1245
Mailing Address - Fax:406-587-1092
Practice Address - Street 1:3820 N. 27TH AVE
Practice Address - Street 2:STE 100
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718
Practice Address - Country:US
Practice Address - Phone:406-587-1245
Practice Address - Fax:406-587-1092
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT8218207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000014211OtherBCBS
MT0100232Medicaid
8408Medicare ID - Type UnspecifiedGROUP