MEDICARE: DR. CLAIRE LAREE OSBORN D.O.

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	340075790	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	341935880034	OTHER	OH	CARESOURCE
2	000000333911	OTHER	OH	ANTHEM
3	1104132	OTHER	OH	CIGNA
4	7713416	OTHER	OH	AETNA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841298296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAIRE LAREE OSBORN D.O.

Provider Business Mailing Address
First Line	:	ACTIVATE HEALTHCARE/ 500 W MULBERRY ST.
Second Line	:	SUITE 101
City	:	BRYAN
State	:	OH
Zip	:	43506
Country	:	US
Telephone Number	:	419-519-3336
Fax Number	:	419-212-9219

Provider Business Practice Location Address
First Line	:	ACTIVATE HEALTHCARE/500 W MULBERRY ST.
Second Line	:	SUITE 101
City	:	BRYAN
State	:	OH
Zip	:	43506
Country	:	US
Telephone Number	:	419-519-3336
Fax Number	:	419-212-9219

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	03/17/2018

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