Provider Demographics
NPI:1528052271
Name:APOSTOL, JOHN G (MD, PC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:APOSTOL
Suffix:
Gender:M
Credentials:MD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:815 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7133
Mailing Address - Country:US
Mailing Address - Phone:541-779-6395
Mailing Address - Fax:541-772-8392
Practice Address - Street 1:815 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-7133
Practice Address - Country:US
Practice Address - Phone:541-779-6395
Practice Address - Fax:541-772-8392
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD07166207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR001909Medicaid
ORA002OtherCHAMPUS IDN
OR6482455OtherCIGNA HEALTH CARE ID
OR001909Medicaid
ORC92108Medicare UPIN