Provider Demographics
NPI:1770184392
Name:OSBORNE, JIMMY LEE JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:LEE
Last Name:OSBORNE
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:477 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-1146
Mailing Address - Country:US
Mailing Address - Phone:606-886-1100
Mailing Address - Fax:606-886-2088
Practice Address - Street 1:477 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1146
Practice Address - Country:US
Practice Address - Phone:606-886-1100
Practice Address - Fax:606-886-2088
Is Sole Proprietor?:No
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY0166421835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist