Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 0101054891 | VA |
Y | 2080P0214X | Pediatric Pulmonologist | 28719 | WA |
N | 2080P0214X | Pediatric Pulmonologist | MD34109 | VA |
NPI | 1275599631 |
---|---|
Provider Name | Dr. John Pilgrim Osborn |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Seattle, WA 98104-1306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 01/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6707297 | (05) | VA |
6711006 | (05) | VA |
6715397 | (05) | VA |
6716369 | (05) | VA |
6716865 | (05) | VA |
F57641 | (02) |