MEDICARE: DR. WENDY W OSBAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS8405	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063463297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WENDY W OSBAN DO

Provider Business Mailing Address
First Line	:	PO BOX 2699
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32513-2699
Country	:	US
Telephone Number	:	850-475-4500
Fax Number	:	850-475-4619

Provider Business Practice Location Address
First Line	:	1549 AIRPORT BLVD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32504-8633
Country	:	US
Telephone Number	:	850-416-7008
Fax Number	:	850-416-7003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	05/31/2011

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