Provider Demographics
NPI:1760860423
Name:OSBORN, STEFAN (MD)
Entity Type:Individual
Prefix:MR
First Name:STEFAN
Middle Name:
Last Name:OSBORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 GREENSBORO AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405
Mailing Address - Country:US
Mailing Address - Phone:205-333-4655
Mailing Address - Fax:205-333-4660
Practice Address - Street 1:701 UNIVERSITY BLVD E
Practice Address - Street 2:STE 604
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401
Practice Address - Country:US
Practice Address - Phone:205-759-6925
Practice Address - Fax:205-759-6926
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.45029208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery