Healthcare Provider Details

I. General information

NPI: 1285657726
Provider Name (Legal Business Name): TIMOTHY E O'LEARY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 STEAM PLANT RD STE 130
GALLATIN TN
37066-3056
US

IV. Provider business mailing address

300 STEAM PLANT RD STE 130
GALLATIN TN
37066-3056
US

V. Phone/Fax

Practice location:
  • Phone: 615-328-3750
  • Fax: 615-328-3758
Mailing address:
  • Phone: 615-328-3750
  • Fax: 615-328-3758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1088
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: