Osborn, Tom

Osborn, Tom is an individual health care provider with primary practice located at 1120 25Th Ave , Black Eagle MT 59414-1037. He recently has only one registered license in Other Service Providers / Contractor, which is considered as his primary health care specialty. Osborn, Tom can be contacted via phone (406) 452-9834.

Contact Information

Primary practice address
1120 25Th Ave Black Eagle MT 59414-1037
Fax: (406) 453-3940
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X 193766 Montana

Profile Details

NPI number 1043680994
LBN Legal business name Osborn, Tom
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2015
Last updated Oct 5th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043680994 NPPES
Montana MEDICAID 193766
Montana MEDICAID 136084

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