Organization Name: | ROBERT N. OSDYKE, INC |
NPI Number: | 1093030173 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT N OSDYKE (OWNER) |
Mailing Address: | 15421 Clayton Rd Suite G1 Ballwin |
State: | MO US |
Postal Code: | 630113161 |
Phone Number: | 6362070444 |
Fax Number: | 6362070446 |
NPI Enumeration Date: | 04/01/2010 |
NPI Last Update Date: | 04/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 000427 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |