MEDICARE: ANTONIO L OSIO MD PA

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	207Q00000X	Family Medicine Physician	0415605	KS

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	:	1609831734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTONIO L OSIO MD PA

Provider Business Mailing Address
First Line	:	2456 N WOODLAWN ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-3902
Country	:	US
Telephone Number	:	316-689-8677
Fax Number	:	316-688-1072

Provider Business Practice Location Address
First Line	:	2456 N WOODLAWN ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67220-3902
Country	:	US
Telephone Number	:	316-689-8677
Fax Number	:	316-688-1072

Authorized Official
Title or Position	:	OWNER
Name	:	ANTONIO L OSIO I
Credential	:	MD
Telephone Number	:	316-689-8677

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	07/08/2015

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