Provider Demographics
NPI:1922207349
Name:OSBORNE, DEBRA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANN
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NORTHSIDE XING
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-2296
Mailing Address - Country:US
Mailing Address - Phone:478-330-7007
Mailing Address - Fax:478-330-6773
Practice Address - Street 1:200 NORTHSIDE XING
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2296
Practice Address - Country:US
Practice Address - Phone:478-330-7007
Practice Address - Fax:478-330-6773
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA442972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry