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General NPI Number Information
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NPI Number | 1730548181
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Entity Type | Individual
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Provider Name | COREY O'REILLY MD
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Gender | Male
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Dates
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Enumeration Date | 02/14/2016
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Last Update Date | 08/30/2024
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Provider Practice Location Address
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Address Line | 300 E HOSPITAL RD
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City | FORT EISENHOWER
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State | GA
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Zip | 30905
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Country | US
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Telephone | 253-968-0369
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E HOSPITAL RD
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City | FORT EISENHOWER
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State | GA
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Zip | 30905
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 30181
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD61321849
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 30181
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License Number State | NE
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