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General NPI Number Information
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NPI Number | 1811524887
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Entity Type | Individual
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Provider Name | EDMOND JOSEPH O'LEARY DO
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Gender | Male
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 1050 REID PKWY STE 200
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City | RICHMOND
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State | IN
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Zip | 47374-1155
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Country | US
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Telephone | 765-983-3960
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Fax | 765-935-8540
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Provider Business Mailing Address
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Address Line | 1100 REID PARKWAY PAYOR ENROLLMENT
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City | RICHMOND
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State | IN
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Zip | 47374
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Country | US
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Telephone | 765-983-3000
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Fax | 765-935-8592
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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 | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 02007714A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 322272
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 322272
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License Number State | NY
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