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General NPI Number Information
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NPI Number | 1477833457
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Entity Type | Organization
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Legal Business Name | PATRICK D O'MEARA, D.O.
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Dates
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Enumeration Date | 08/23/2011
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 330 S 9TH ST
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City | MONTROSE
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State | CO
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Zip | 81401-4312
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Country | US
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Telephone | 970-240-3775
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Fax | 970-340-3777
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Provider Business Mailing Address
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Address Line | 330 S 9TH ST
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City | MONTROSE
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State | CO
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Zip | 81401-4312
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Country | US
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Telephone | 970-240-3775
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Fax | 970-340-3777
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Authorized Official
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Title or Position | PHYSICIAN
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Name | PATRICK D O'MEARA
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Credential | D.O.
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Telephone | 970-240-3775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30545
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License Number State | CO
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