Provider Demographics
NPI:1871713032
Name:OBRIEN ORTHOPEDIC PC
Entity type:Organization
Organization Name:OBRIEN ORTHOPEDIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:OBRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-757-2550
Mailing Address - Street 1:6490 HIGHWAY 72
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35645
Mailing Address - Country:US
Mailing Address - Phone:256-757-2550
Mailing Address - Fax:256-757-5552
Practice Address - Street 1:6490 HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35645
Practice Address - Country:US
Practice Address - Phone:256-757-2550
Practice Address - Fax:256-757-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty