Provider Demographics
NPI:1164689931
Name:O'BRIEN PARADIS, KATIE ALLISON (MD)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:ALLISON
Last Name:O'BRIEN PARADIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKES
Mailing Address - State:ND
Mailing Address - Zip Code:58474-2502
Mailing Address - Country:US
Mailing Address - Phone:701-742-3600
Mailing Address - Fax:701-742-3861
Practice Address - Street 1:1200 N 7TH ST
Practice Address - Street 2:
Practice Address - City:OAKES
Practice Address - State:ND
Practice Address - Zip Code:58474-2502
Practice Address - Country:US
Practice Address - Phone:701-742-3600
Practice Address - Fax:701-742-3861
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND12069207R00000X
MN52506207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine