Organization
EVAN D. O'BRIEN, M.D., P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY OWENS (BILLING MANAGER)
(856) 845-0707
Entity
Organization
Contact information
Practice address
1225 N BROAD ST, SUITE 3, WEST DEPTFORD, NJ 08096-1203
(856) 845-0707
(856) 845-0082
Mailing address
1225 N BROAD ST, SUITE 3, WEST DEPTFORD, NJ 08096-1203
(856) 845-0707
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
MA63525
NJ
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
25MA07777400
NJ
363AS0400X
Surgical Physician Assistant
Primary
25MP00021200
NJ
363AS0400X
Surgical Physician Assistant
25MP00100300
NJ
363LF0000X
Family Nurse Practitioner
26NJ00027700
NJ
Other
Enumeration date
09/16/2008
Last updated
06/11/2009
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