Provider Demographics
NPI:1629129192
Name:OBRIEN, FREDERICK PAUL III (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:PAUL
Last Name:OBRIEN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1044 HIGHGRASS CT
Mailing Address - Street 2:1044 HIGHGRASS COURT
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-7083
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 EAST HOSPITAL RD
Practice Address - Street 2:DWIGHT D. EISENHOWER ARMY MEDICAL CENTER
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:30905
Practice Address - Country:US
Practice Address - Phone:706-787-5811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-13
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD61252419207X00000X
GA075294207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery