Provider Demographics
NPI:1710011507
Name:O'BRIEN, PAUL JOSEPH JR (DC,)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:JOSEPH
Last Name:O'BRIEN
Suffix:JR
Gender:M
Credentials:DC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 TAUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-6103
Mailing Address - Country:US
Mailing Address - Phone:401-223-0111
Mailing Address - Fax:401-490-9779
Practice Address - Street 1:73 TAUNTON AVE
Practice Address - Street 2:
Practice Address - City:SEEKONK
Practice Address - State:MA
Practice Address - Zip Code:02771
Practice Address - Country:US
Practice Address - Phone:401-223-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00417111N00000X
MA2449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI21228-7OtherBLUE CROSS BLUE SHIELD
352200OtherHARVARD PILGRIM
RI408954OtherBLUE CHIP
7823303OtherAETNA
RI408954OtherBLUE CHIP
U80462Medicare UPIN