Healthcare Provider Details

I. General information

NPI: 1306950159
Provider Name (Legal Business Name): JAMES O'BRIEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3545 OLENTANGY RIVER RD SUITE 211
COLUMBUS OH
43214-3907
US

IV. Provider business mailing address

3545 OLENTANGY RIVER RD SUITE 211
COLUMBUS OH
43214-3907
US

V. Phone/Fax

Practice location:
  • Phone: 614-267-8585
  • Fax: 614-267-9793
Mailing address:
  • Phone: 614-267-8585
  • Fax: 614-267-9793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35073432
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35073432
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: