Individual
JOHN CLARK OSBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 2ND AVE SW, 107-B, MIAMI, OK 74354-6743
(918) 540-7730
(918) 540-7797
Mailing address
5300 N INDEPENDENCE AVE, 280, OKLAHOMA CITY, OK 73112-5556
(918) 540-7730
(918) 540-7797
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
15646
OK
207Q00000X
Family Medicine Physician
Primary
15646
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100096540A
—
OK
05
—
200468380O
—
OK
05
—
207709718
—
MO
05
—
500156005
—
MO
Enumeration date
02/23/2006
Last updated
04/05/2017
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