Individual
JOSEPH M O'BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5120 VILLAGE SQUARE DR, SUITE 103, PADUCAH, KY 42001-9060
(270) 442-0240
(270) 442-9599
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-0834
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
36713
KY
207Q00000X
Family Medicine Physician
01044033A
IN
207Q00000X
Family Medicine Physician
Primary
36713
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64880495
—
KY
Enumeration date
09/27/2005
Last updated
04/27/2020
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