Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | MD0000028032 | TN |
N | 207X00000X | Orthopaedic Surgeon | MD0000028032 | TN |
NPI | 1750323911 |
---|---|
Provider Name | Thomas J Obrien |
First Address | Nashville, TN 37211-3982 |
Second Address | Nashville, TN 37217-2626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 07/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200042899 | RAILROAD MEDICARE (01) | TN |
3800220 | (05) | TN |
G26811 | (02) | TN |