MEDICARE: DR. DAVID MICHAEL 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	2083X0100X	Occupational Medicine Physician	18662	AZ
2	2083A0100X	Aerospace Medicine Physician	18662	AZ

General Provider Information

NPI Number	:	1740269646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MICHAEL O'BRIEN M.D.

Provider Business Mailing Address
First Line	:	6500 S. MACARTHUR BLVD
Second Line	:	CIVIL AEROSPACE MEDICINE INSTITUTE, BLDG 13 AAM-300
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73169
Country	:	US
Telephone Number	:	405-954-8097
Fax Number	:	757-225-4711

Provider Business Practice Location Address
First Line	:	6500 S. MACARTHUR BLVD
Second Line	:	BLDG 13 AAM-300
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73169
Country	:	US
Telephone Number	:	405-954-8097
Fax Number	:	757-225-4711

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	03/01/2018

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