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NPI Code Detail

MEDICARE: MR. TIMOTHY J O'SHEA

MEDICARE: MR. TIMOTHY J O'SHEA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152WC0802XCorneal and Contact Management Optometrist633NV
2152WC0802XCorneal and Contact Management OptometristOEG002150PA

General Provider Information

NPI Number : 1033362074
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY J O'SHEA
Provider Business Mailing Address
First Line : 5065 PYRAMID LAKE RD
Second Line :
City : SPARKS
State : NV
Zip : 89436-7703
Country : US
Telephone Number : 775-425-9335
Fax Number : 775-425-9337
Provider Business Practice Location Address
First Line : 5065 PYRAMID LAKE RD
Second Line :
City : SPARKS
State : NV
Zip : 89436-7703
Country : US
Telephone Number : 775-425-9335
Fax Number : 775-425-9337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2008
Last Update Date : 11/03/2008

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Directions to “ MR. TIMOTHY J O'SHEA ” Practice Location

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