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General NPI Number Information
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NPI Number | 1003867771
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Entity Type | Individual
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Provider Name | KEVIN O'BRIEN MD
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1432 E 9TH ST
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City | ROCHESTER
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State | IN
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Zip | 46975-8931
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Country | US
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Telephone | 574-223-4337
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Fax | 574-406-9116
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Provider Business Mailing Address
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Address Line | 1400 E 9TH ST
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City | ROCHESTER
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State | IN
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Zip | 46975-8937
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Country | US
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Telephone | 574-224-1048
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Fax | 574-406-9116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01036827
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License Number State | IN
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