Provider Demographics
NPI:1871914820
Name:OSBORN, TRUMAN FORBES (PA-C)
Entity type:Individual
Prefix:MR
First Name:TRUMAN
Middle Name:FORBES
Last Name:OSBORN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:T.
Other - Middle Name:FORBES
Other - Last Name:OSBORN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:JD LANKENAU PAVILION, MEZZANINE
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:484-476-1000
Mailing Address - Fax:484-476-9000
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:JD LANKENAU PAVILION, MEZZANINE
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:484-476-1000
Practice Address - Fax:484-476-9000
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000638L363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical