Provider Demographics
NPI:1417949199
Name:O'BRIEN, KEVIN M (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 STEAM PLANT RD
Mailing Address - Street 2:STE. 300
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3032
Mailing Address - Country:US
Mailing Address - Phone:615-451-3929
Mailing Address - Fax:615-451-4845
Practice Address - Street 1:300 STEAM PLANT RD
Practice Address - Street 2:STE. 300
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3032
Practice Address - Country:US
Practice Address - Phone:615-451-3929
Practice Address - Fax:615-451-4845
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN8717207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3160530Medicaid
TNB02824Medicare UPIN
TN3160530Medicaid