Provider Demographics
NPI:1972686186
Name:HARSCH AND OSBORNE, MD, PC
Entity Type:Organization
Organization Name:HARSCH AND OSBORNE, MD, PC
Other - Org Name:SOUTHEASTERN PRIMARY CARE PHYSICIANS
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-716-7999
Mailing Address - Street 1:105 CARNEGIE PL
Mailing Address - Street 2:STE 103
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-3980
Mailing Address - Country:US
Mailing Address - Phone:770-716-7999
Mailing Address - Fax:
Practice Address - Street 1:105 CARNEGIE PL
Practice Address - Street 2:STE 103
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-3980
Practice Address - Country:US
Practice Address - Phone:770-716-7999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID
GAGRP1436Medicare PIN