Doctor Name: | DR. COLLEEN F. O'BRIEN |
NPI Number: | 1942308184 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 052926 |
Business Practice Address: | 609 E Gibson St Covington, LA - 704332980 |
Business Phone Number: | 9858093860 |
Business Fax Number: | |
Mailing Address: | 10044 Judy Dr, RIVER RIDGE |
State: | LA |
Postal Code: | 701231463 |
Phone Number: | 5047370411 |
Fax Number: | |
NPI Enumeration Date: | 09/20/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 052926 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |