Provider Demographics
NPI:1194726992
Name:OBRYAN, WILLIAM M (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:M
Last Name:OBRYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 23229
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42304-3229
Mailing Address - Country:US
Mailing Address - Phone:270-688-1330
Mailing Address - Fax:270-688-1338
Practice Address - Street 1:1000 BRECKENRIDGE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-0839
Practice Address - Country:US
Practice Address - Phone:270-685-7150
Practice Address - Fax:270-685-7173
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2016-03-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY20619207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6420619600Medicaid
IN100008110Medicaid
KY3397741Medicare PIN
C68292Medicare UPIN
C68292Medicare UPIN