MEDICARE: DR. RICHARD KENNETH OSENBACH 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	207T00000X	Neurological Surgery Physician	200100756	NC
2	207T00000X	Neurological Surgery Physician	MD037165E	PA
3	208VP0000X	Pain Medicine Physician	MD037165E	PA

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	:	1396836789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD KENNETH OSENBACH M.D.

Provider Business Mailing Address
First Line	:	307 S FRONT ST
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17104-1621
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4310 LONDDERRY ROAD
Second Line	:	SUITE 202
City	:	HARRISBURG
State	:	PA
Zip	:	17109-5329
Country	:	US
Telephone Number	:	717-791-2520
Fax Number	:	717-920-4361

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	04/03/2015

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