Provider Demographics
NPI:1982608386
Name:OBRIEN, LINA M (MD)
Entity Type:Individual
Prefix:
First Name:LINA
Middle Name:M
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6060 N OAK TRFY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-5130
Mailing Address - Country:US
Mailing Address - Phone:816-941-0800
Mailing Address - Fax:816-941-0080
Practice Address - Street 1:4370 W 109TH ST
Practice Address - Street 2:SUITE 350
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1361
Practice Address - Country:US
Practice Address - Phone:816-941-0800
Practice Address - Fax:816-941-0080
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2022-01-13
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Provider Licenses
StateLicense IDTaxonomies
KS0429396208C00000X
MO2001023249208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100404020AMedicaid
MO205424005Medicaid
MO205424005Medicaid
MOG83504Medicare UPIN
KS100404020AMedicaid