Individual
TIMOTHY D. O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
819 STATE ROUTE 664 N STE B, LOGAN, OH 43138-8540
(740) 380-8140
(740) 380-8150
Mailing address
PO BOX 228, LOGAN, OH 43138-0228
(740) 380-1300
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35076169
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2272964
—
OH
Enumeration date
05/01/2006
Last updated
11/23/2020
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