MEDICARE: KEVIN M. O'BRIEN 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
1	207RN0300X	Nephrology Physician	8717	TN

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	:	1417949199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN M. O'BRIEN M.D.

Provider Business Mailing Address
First Line	:	300 STEAM PLANT RD
Second Line	:	STE. 300
City	:	GALLATIN
State	:	TN
Zip	:	37066-3032
Country	:	US
Telephone Number	:	615-451-3929
Fax Number	:	615-451-4845

Provider Business Practice Location Address
First Line	:	300 STEAM PLANT RD
Second Line	:	STE. 300
City	:	GALLATIN
State	:	TN
Zip	:	37066-3032
Country	:	US
Telephone Number	:	615-451-3929
Fax Number	:	615-451-4845

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	10/29/2013

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