Healthcare Provider Details

I. General information

NPI: 1275947517
Provider Name (Legal Business Name): TODD GRAHAM OSBORNE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2014
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL PENSACOLA 6000 US-98
PENSACOLA FL
32512-0001
US

IV. Provider business mailing address

NAVAL HOSPITAL PENSACOLA 6000 US-98
PENSACOLA FL
32512-0001
US

V. Phone/Fax

Practice location:
  • Phone: 850-505-6601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberOS13794
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: