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General NPI Number Information
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NPI Number | 1235348285
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Entity Type | Individual
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Provider Name | NATHAN FORREST OSBORN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 62968 O B RILEY RD SUITE E-2
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City | BEND
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State | OR
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Zip | 97701-9442
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Country | US
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Telephone | 541-728-0978
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Fax | 541-728-0979
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Provider Business Mailing Address
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Address Line | 62968 O B RILEY RD SUITE E-2
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City | BEND
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State | OR
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Zip | 97701-9442
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Country | US
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Telephone | 541-728-0978
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Fax | 541-728-0979
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 77432
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD154386
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD154386
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License Number State | OR
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