Provider Demographics
NPI:1437318128
Name:OBRYON FAMILY MEDICINE INC
Entity Type:Organization
Organization Name:OBRYON FAMILY MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:OBRYON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-371-3980
Mailing Address - Street 1:898 BEAVER DR
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-2512
Mailing Address - Country:US
Mailing Address - Phone:814-371-3980
Mailing Address - Fax:814-371-8317
Practice Address - Street 1:898 BEAVER DR
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2512
Practice Address - Country:US
Practice Address - Phone:814-371-3980
Practice Address - Fax:814-371-8317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1021391470001Medicaid
PA1021391470001Medicaid