Basic Information
| Provider Information | |||||||||
| NPI: | 1861615155 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'BRIEN | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | MARK | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 911 E. 20TH ST | ||||||||
| Address2: | STE 300 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053221300 | ||||||||
| FaxNumber: | 6053221301 | ||||||||
| Practice Location | |||||||||
| Address1: | 911 E 20TH ST STE 300 | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571051045 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053221300 | ||||||||
| FaxNumber: | 6053221301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2007 | ||||||||
| LastUpdateDate: | 10/31/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 2014-01725 | NC | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | 10105 | SD | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.