MEDICARE: MICHAEL SEAN OBRIEN D.O.

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
1	207X00000X	Orthopaedic Surgery Physician	3481	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164496238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SEAN OBRIEN D.O.

Provider Business Mailing Address
First Line	:	PO BOX 890358
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73189-0358
Country	:	US
Telephone Number	:	405-759-2663
Fax Number	:	405-759-3827

Provider Business Practice Location Address
First Line	:	3110 SW 89TH ST
Second Line	:	SUITE 200C
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7920
Country	:	US
Telephone Number	:	405-759-2663
Fax Number	:	405-759-3827

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	10/26/2011

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