Provider Demographics
NPI:1437383718
Name:OSTRANDER, TROY JUN (DO)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:JUN
Last Name:OSTRANDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:BELDEN
Mailing Address - State:MS
Mailing Address - Zip Code:38826-0355
Mailing Address - Country:US
Mailing Address - Phone:662-231-6381
Mailing Address - Fax:
Practice Address - Street 1:4637 WHITECHAPEL LN
Practice Address - Street 2:
Practice Address - City:BELDEN
Practice Address - State:MS
Practice Address - Zip Code:38826-9780
Practice Address - Country:US
Practice Address - Phone:662-231-6381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20653207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01721241Medicaid
302I935111Medicare Oscar/Certification