MEDICARE: TIMOTHY OLEARY OD

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
1	152W00000X	Optometrist	3748-T582	OH

General Provider Information

NPI Number	:	1689097271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY OLEARY OD

Provider Business Mailing Address
First Line	:	1233 HERSCHEL WOODS LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-4335
Country	:	US
Telephone Number	:	513-321-2015
Fax Number	:

Provider Business Practice Location Address
First Line	:	1233 HERSCHEL WOODS LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-4335
Country	:	US
Telephone Number	:	513-321-2015
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIMOTHY OLEARY
Credential	:
Telephone Number	:	513-321-2015

Provider Enumeration Date	:	02/02/2014
Last Update Date	:	02/02/2014

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