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NPI Code Detail

MEDICARE: CHARLES OZBORN MD

MEDICARE: CHARLES OZBORN MD
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
1207Q00000XFamily Medicine Physician05006MS

Other Identifiers

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

General Provider Information

NPI Number : 1053373662
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES OZBORN MD
Provider Business Mailing Address
First Line : 1301 VETERANS MEMORIAL BLVD
Second Line :
City : EUPORA
State : MS
Zip : 39744-2064
Country : US
Telephone Number : 662-258-7200
Fax Number : 662-258-5871
Provider Business Practice Location Address
First Line : 1301 VETERANS MEMORIAL BLVD
Second Line :
City : EUPORA
State : MS
Zip : 39744-2064
Country : US
Telephone Number : 662-258-7200
Fax Number : 662-258-5871
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 02/21/2011

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Directions to “ CHARLES OZBORN MD” Practice Location

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