Provider Demographics
NPI:1619084944
Name:O'BRIEN, RICHARD F (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:F
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 1:4545 E 9TH AVE STE 670
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3918
Mailing Address - Country:US
Mailing Address - Phone:303-423-0758
Mailing Address - Fax:303-423-0758
Practice Address - Street 1:4545 E 9TH AVE STE 670
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3918
Practice Address - Country:US
Practice Address - Phone:303-423-0758
Practice Address - Fax:303-423-0758
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO24590174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01245901Medicaid
COD24472Medicare UPIN
COA5628Medicare ID - Type Unspecified