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1013061118 NPI number — MARCUS WHITFIELD OSBORNE LAT, ATC

NPI Number: 1013061118
Health Care Provider/Practitioner: MARCUS WHITFIELD OSBORNE LAT, ATC

Information about “1013061118” NPI (MARCUS WHITFIELD OSBORNE LAT, ATC) exists in 1013061118 in HTML format HTML  |  1013061118 in plain Text format TXT  |  1013061118 in PDF (Portable Document Format) PDF  |  1013061118 in an XML format XML  formats.

NPI Number : 1013061118 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013061118",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "OSBORNE",
    "FirstName": "MARCUS",
    "MiddleName": "WHITFIELD",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "LAT, ATC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1129 WINDY HILL DR NW",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CONOVER",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28613-9095",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "828-326-2272",
    "MailingAddressFaxNumber": "828-322-6559",
    "FirstLinePracticeLocationAddress": "810 FAIRGROVE CHURCH RD",
    "SecondLinePracticeLocationAddress": "CVMC-CENTER FOR REHABILITATION",
    "PracticeLocationAddressCityName": "HICKORY",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28602-9617",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "828-326-2272",
    "PracticeLocationAddressFaxNumber": "828-322-6559",
    "EnumerationDate": "01/23/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "2255A2300X",
        "TaxonomyName": "Athletic Trainer",
        "LicenseNumber": "0733",
        "LicenseNumberStateCode": "NC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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