Basic Information
| Provider Information | |||||||||
| NPI: | 1790186484 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OSGOOD | ||||||||
| FirstName: | SETH | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2520 BROADWAY ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782151140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105951019 | ||||||||
| FaxNumber: | 2102513194 | ||||||||
| Practice Location | |||||||||
| Address1: | 24 AIRPORT RD STE 302 | ||||||||
| Address2: | |||||||||
| City: | WEST LEBANON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037841663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8886447668 | ||||||||
| FaxNumber: | 6038560372 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2014 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP126443 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 075358-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.