MEDICARE: JOHN JAY OSBORN M.D.

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	2086S0129X	Vascular Surgery Physician	20033	SC
2	207Q00000X	Family Medicine Physician	20033	SC

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	:	1003027822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN JAY OSBORN M.D.

Provider Business Mailing Address
First Line	:	2817 ROCK MERRITT AVENUE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:	910-907-6069

Provider Business Practice Location Address
First Line	:	2817 ROCK MERRITT AVENUE
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-0001
Country	:	US
Telephone Number	:	910-907-8922
Fax Number	:	910-907-6069

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	02/03/2026

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Directions to “ JOHN JAY OSBORN M.D.” Practice Location

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