MEDICARE: DR OSH & ASSOCIATES PC

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	213EP1101X	Primary Podiatric Medicine Podiatrist

General Provider Information

NPI Number	:	1942302146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR OSH & ASSOCIATES PC

Provider Business Mailing Address
First Line	:	105 WEXFORD CIRCLE
Second Line	:
City	:	BONAIRE
State	:	GA
Zip	:	31005
Country	:	US
Telephone Number	:	478-328-6466
Fax Number	:	478-328-1338

Provider Business Practice Location Address
First Line	:	1043 N HOUSTON RD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093
Country	:	US
Telephone Number	:	478-328-6466
Fax Number	:	478-328-1338

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	GIGI DY
Credential	:
Telephone Number	:	478-328-6466

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	07/31/2008

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