Provider Demographics
NPI:1861463721
Name:OSBORNE, LINDA S (DO)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 TECH CENTER DR STE 250
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1987
Mailing Address - Country:US
Mailing Address - Phone:614-944-4800
Mailing Address - Fax:614-944-4750
Practice Address - Street 1:701 TECH CENTER DR
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-1987
Practice Address - Country:US
Practice Address - Phone:614-396-2684
Practice Address - Fax:614-396-2480
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34008319208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2499372Medicaid
OH0335379OtherRAILROAD MEDICARE
OH4137243Medicare PIN
I10593Medicare UPIN