Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1034 | OH |
NPI | 1811071327 |
---|---|
Provider Name | Dr. Kenneth Jeffery Osborn |
First Address | Columbus, OH 43235-2780 |
Second Address | Columbus, OH 43235-2780 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 24/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000119164 | ANTHEM PROVIDER # (01) | OH |
124059000 | OFWC PROVIDER # (01) | OH |
13240-0001 | CARE SOURCE PIN # (01) | OH |
2240 | (05) | OH |
311229921-00 | OBWC PROVIDER # (01) | OH |
311229921-002 | CENTRAL BENEFITS # (01) | OH |
311-229921026 | CARESOURCE PROVIDER # (01) | OH |
350055581 | RAILROAD MEDICARE # (01) | OH |
T48016 | (02) | OH |