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General NPI Number Information
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NPI Number | 1760578900
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Entity Type | Organization
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Legal Business Name | THE O'BRIEN HEALTH CENTER
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 18 MANSION ST
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City | WINOOSKI
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State | VT
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Zip | 05404-2030
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Country | US
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Telephone | 802-655-3000
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Fax | 802-655-7753
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Provider Business Mailing Address
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Address Line | 18 MANSION ST
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City | WINOOSKI
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State | VT
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Zip | 05404-2030
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Country | US
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Telephone | 802-655-3000
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Fax | 802-655-7753
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES K. O'BRIEN
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Credential | M.D.
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Telephone | 802-655-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 8121
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License Number State | VT
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