Healthcare Provider Details
I. General information
NPI: 1437318128
Provider Name (Legal Business Name): OBRYON FAMILY MEDICINE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2008
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
898 BEAVER DR
DU BOIS PA
15801-2512
US
IV. Provider business mailing address
898 BEAVER DR
DU BOIS PA
15801-2512
US
V. Phone/Fax
- Phone: 814-371-3980
- Fax: 814-371-8317
- Phone: 814-371-3980
- Fax: 814-371-8317
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JAMES
E
OBRYON
Title or Position: OWNER
Credential: MD
Phone: 814-371-3980