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NPI Code Detail

MEDICARE: MICHAEL FREDERICK OSBORNE M.D.

MEDICARE: MICHAEL FREDERICK OSBORNE 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
12084P0800XPsychiatry PhysicianMD00046130WA
22084P0800XPsychiatry PhysicianMD0000041913TN
32084P0800XPsychiatry Physician054643GA

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 : 1720172687
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL FREDERICK OSBORNE M.D.
Provider Business Mailing Address
First Line : 2200 MORRIS HILL RD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-2818
Country : US
Telephone Number : 423-499-1204
Fax Number : 423-499-2320
Provider Business Practice Location Address
First Line : 2200 MORRIS HILL RD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-2818
Country : US
Telephone Number : 423-499-1204
Fax Number : 423-499-2320
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 08/21/2007

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