1740269646 NPI number — DR. DAVID MICHAEL O'BRIEN M.D.

Table of content: DR. DAVID MICHAEL O'BRIEN M.D. (NPI 1740269646)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740269646 NPI number — DR. DAVID MICHAEL O'BRIEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'BRIEN
Provider First Name:
DAVID
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1740269646
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6500 S. MACARTHUR BLVD
Provider Second Line Business Mailing Address:
CIVIL AEROSPACE MEDICINE INSTITUTE, BLDG 13 AAM-300
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-954-8097
Provider Business Mailing Address Fax Number:
757-225-4711

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6500 S. MACARTHUR BLVD
Provider Second Line Business Practice Location Address:
BLDG 13 AAM-300
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-954-8097
Provider Business Practice Location Address Fax Number:
757-225-4711
Provider Enumeration Date:
01/10/2006

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: 2083X0100X , with the licence number:  18662 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2083A0100X , with the licence number: 18662 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com