Provider Demographics
NPI:1437211794
Name:O'BRIEN, BARBARA ANNE (DO)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANNE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CLARKSON RD
Mailing Address - Street 2:
Mailing Address - City:ELLISVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2278
Mailing Address - Country:US
Mailing Address - Phone:636-230-5050
Mailing Address - Fax:636-230-5057
Practice Address - Street 1:225 CLARKSON RD
Practice Address - Street 2:
Practice Address - City:ELLISVILLE
Practice Address - State:MO
Practice Address - Zip Code:63011-2278
Practice Address - Country:US
Practice Address - Phone:636-685-7715
Practice Address - Fax:314-590-5916
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003000621207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000000014182OtherESSENCE
MO182228OtherBCBS
633328OtherHEALTHLINK
322212OtherGHP
7432465OtherAETNA
00000001482OtherESSENCE
MO209258102Medicaid
2312375OtherUHC
IL036117870OtherBCBS IL
8008001OtherCIGNA
633328OtherHEALTHLINK
ILK36993Medicare PIN
8008001OtherCIGNA
2312375OtherUHC