Provider Demographics
NPI:1316029960
Name:DC OBRIEN ENTERPRISES INC
Entity Type:Organization
Organization Name:DC OBRIEN ENTERPRISES INC
Other - Org Name:ORLEANS FAMILY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:OBRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:812-865-3350
Mailing Address - Street 1:260 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:IN
Mailing Address - Zip Code:47452-1724
Mailing Address - Country:US
Mailing Address - Phone:812-865-3350
Mailing Address - Fax:812-865-3814
Practice Address - Street 1:260 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:IN
Practice Address - Zip Code:47452-1724
Practice Address - Country:US
Practice Address - Phone:812-865-3350
Practice Address - Fax:812-865-3814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002666A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1316029960Medicare PIN
INC25407Medicare UPIN