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NPI Code Detail

MEDICARE: MICHAEL O'BRYAN M.D.

MEDICARE: MICHAEL O'BRYAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician94-08628KS
2208100000XPhysical Medicine & Rehabilitation Physician04-42408KS

General Provider Information

NPI Number : 1104207091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL O'BRYAN M.D.
Provider Business Mailing Address
First Line : 13875 W 115TH TER
Second Line :
City : OLATHE
State : KS
Zip : 66062-7937
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 13875 W 115TH TER
Second Line :
City : OLATHE
State : KS
Zip : 66062-7937
Country : US
Telephone Number : 913-323-7107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2015
Last Update Date : 04/24/2023

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