Healthcare Provider Details

I. General information

NPI: 1548072432
Provider Name (Legal Business Name): JOSEPH O'BRIEN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 02/07/2026
Certification Date: 02/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 COMMERCE DR
NEW BERN NC
28562-2212
US

IV. Provider business mailing address

1308 COMMERCE DR
NEW BERN NC
28562-2212
US

V. Phone/Fax

Practice location:
  • Phone: 252-649-2728
  • Fax:
Mailing address:
  • Phone: 252-649-2728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-15312
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: