Individual
STACY CLARENCE OSBORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5521 MONTGOMERY RD, NORWOOD, OH 45212-1848
(513) 351-6300
Mailing address
5521 MONTGOMERY RD, NORWOOD, OH 45212-1848
(513) 351-6300
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36002140
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0520207
—
OH
01
—
480002256
RAILROAD MEDICARE
OH
Enumeration date
05/27/2005
Last updated
05/17/2019
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