Provider Demographics
NPI:1720196736
Name:OSIO, ANTONIO L (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:L
Last Name:OSIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S HILLSIDE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-2128
Mailing Address - Country:US
Mailing Address - Phone:316-682-6551
Mailing Address - Fax:316-682-8151
Practice Address - Street 1:201 S HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-2128
Practice Address - Country:US
Practice Address - Phone:316-682-6551
Practice Address - Fax:316-682-8151
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-15605207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine