Healthcare Provider Details

I. General information

NPI: 1164818084
Provider Name (Legal Business Name): PATRICK MICHAEL O'LEARY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PATRICK MICHAEL O'LEARY M.A.

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

580 PARK AVE W
MANSFIELD OH
44906-3722
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 833-510-4357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number34.013158
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34.013158
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: