Individual
DEVRON LEE KELLEY OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D. O.
Contact information
Practice address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-5175
Mailing address
1102 W 32ND ST, JOPLIN, MO 64804-3503
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0000000000
MO
207R00000X
Internal Medicine Physician
Primary
E-12235
AR
Other
Enumeration date
06/22/2016
Last updated
06/05/2019
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