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General NPI Number Information
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NPI Number | 1043487143
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL O'BRIEN O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 08/02/2013
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Provider Practice Location Address
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Address Line | 1140 HAMMOND DR BLDG E SUITE 5100
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City | ATLANTA
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State | GA
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Zip | 30328-5338
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Country | US
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Telephone | 770-394-4000
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Fax | 770-913-0841
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Provider Business Mailing Address
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Address Line | 871 PENN AVE NE
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City | ATLANTA
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State | GA
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Zip | 30309-4228
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Country | US
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Telephone | 914-472-3937
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Fax | 770-913-0841
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 006248
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11832
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1895
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00601800
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 002704
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License Number State | CT
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