Healthcare Provider Details

I. General information

NPI: 1659804193
Provider Name (Legal Business Name): MEGAN LINDSEY OBRIEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 04/17/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 N BALLAS RD DEPT RADIOLOGY
SAINT LOUIS MO
63131-2329
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-5170
  • Fax: 314-996-4261
Mailing address:
  • Phone: 314-996-5170
  • Fax: 314-996-4261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2023044613
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: