Provider Demographics
NPI:1528037710
Name:O'BRIEN, MICHAEL PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 E CENTRAL AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LA FOLLETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37766-2778
Mailing Address - Country:US
Mailing Address - Phone:423-907-1300
Mailing Address - Fax:423-907-1301
Practice Address - Street 1:919 E CENTRAL AVE STE 202
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-2778
Practice Address - Country:US
Practice Address - Phone:423-907-1300
Practice Address - Fax:423-907-1301
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD37934207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1512161Medicaid
TNP00082430OtherRAILROAD MEDICARE
TNTN01J6OtherJOHN DEERE HEALTHCARE
TN4068292OtherBLUE CROSS BLUE SHIELD
TNDB0103OtherRAILROAD MEDICARE
H91725Medicare UPIN
TNDB0103OtherRAILROAD MEDICARE
3886722Medicare ID - Type Unspecified
TN1512161Medicaid