| O'bryan Family Medicine Pllc | |
|
5120 Village Square Dr Suite 103 Paducah KY 42001-9060 | |
| (270) 442-0240 | |
| Not Available |
| Full Name | O'bryan Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5120 Village Square Dr, Paducah, Kentucky |
| Authorized Official Name and Position | Joseph M O'bryan (OWNER) |
| Authorized Official Contact | 2704420240 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| O'bryan Family Medicine Pllc Po Box 9150 Paducah KY 42002-9150 Ph: (270) 744-9600 | O'bryan Family Medicine Pllc 5120 Village Square Dr Suite 103 Paducah KY 42001-9060 Ph: (270) 442-0240 |
| NPI Number | 1235367442 |
|---|---|
| Provider Enumeration Date | 06/25/2009 |
| Last Update Date | 12/19/2011 |
| Medicare PECOS PAC ID | 5799831533 |
|---|---|
| Medicare Enrollment ID | O20090921000531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235367442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 36713 (Kentucky) | Primary |
| Provider Name | Joseph Obryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770570400 PECOS PAC ID: 2264588094 Enrollment ID: I20090921000508 |
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