Healthcare Provider Details

I. General information

NPI: 1629263421
Provider Name (Legal Business Name): CHRISTOPHER PATRICK O'BRIEN JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 04/18/2020
Certification Date: 04/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6311 KINGSTON PIKE SUITE 6W
KNOXVILLE TN
37919-4906
US

IV. Provider business mailing address

6311 KINGSTON PIKE SUITE 6W
KNOXVILLE TN
37919-4906
US

V. Phone/Fax

Practice location:
  • Phone: 865-262-8473
  • Fax: 865-262-8550
Mailing address:
  • Phone: 865-262-8473
  • Fax: 865-262-8550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD-49470
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA116707
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician
License NumberMD-49470
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: