Provider Demographics
NPI:1093026437
Name:OSBORN, AUSTIN BALLARD (MD)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:BALLARD
Last Name:OSBORN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:875 W POPLAR AVE STE 23-377
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-2513
Mailing Address - Country:US
Mailing Address - Phone:901-501-7039
Mailing Address - Fax:877-578-2807
Practice Address - Street 1:875 W POPLAR AVE STE 23-377
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-2513
Practice Address - Country:US
Practice Address - Phone:901-501-7039
Practice Address - Fax:877-578-2807
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN510322084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry