Individual
JOHN J. O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2630 HIGHWAY K, O FALLON, MO 63368-6624
(636) 240-5454
(618) 980-5335
Mailing address
2630 HIGHWAY K, O FALLON, MO 63368-6624
(636) 240-5454
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R3E76
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080171320
RAILROAD MEDICARE
MO
Enumeration date
02/22/2006
Last updated
02/24/2021
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