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Individual

DR. JEFFREY SHANE OSBORNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3469 N. MAYO TRAIL, PIKEVILLE, KY 41501
(606) 437-7702
(606) 437-2307
Mailing address
3469 MORTH MAYO TRAIL, PIKEVILLE, KY 41501
(606) 437-7702
(606) 437-2307

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1230-DT
KY
152WL0500X
Low Vision Rehabilitation Optometrist
1230- DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003960634
KY
05
77012300
KY
Enumeration date
01/22/2007
Last updated
03/04/2009
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