1437211794 NPI number — BARBARA ANNE O'BRIEN DO

Table of content: BARBARA ANNE O'BRIEN DO (NPI 1437211794)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437211794 NPI number — BARBARA ANNE O'BRIEN DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'BRIEN
Provider First Name:
BARBARA
Provider Middle Name:
ANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437211794
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 CLARKSON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLISVILLE
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63011-2278
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-230-5050
Provider Business Mailing Address Fax Number:
636-230-5057

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 CLARKSON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELLISVILLE
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63011-2278
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-685-7715
Provider Business Practice Location Address Fax Number:
314-590-5916
Provider Enumeration Date:
12/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207QA0505X , with the licence number:  2003000621 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000014182 . This is a "ESSENCE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 182228 . This is a "BCBS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 633328 . This is a "HEALTHLINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 322212 . This is a "GHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7432465 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00000001482 . This is a "ESSENCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 209258102 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2312375 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 036117870 . This is a "BCBS IL" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 8008001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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