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NPI Code Detail

MEDICARE: DR. PATRICK MICHAEL O'LEARY D.O.

MEDICARE: DR. PATRICK MICHAEL O'LEARY D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083A0300XAddiction Medicine (Preventive Medicine) Physician34.013158OH
2208D00000XGeneral Practice Physician34.013158OH

General Provider Information

NPI Number : 1164818084
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICK MICHAEL O'LEARY D.O.
Provider Business Mailing Address
First Line : 4600 MONTGOMERY RD STE 400
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-2600
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 580 PARK AVE W
Second Line :
City : MANSFIELD
State : OH
Zip : 44906-3722
Country : US
Telephone Number : 833-510-4357
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2015
Last Update Date : 11/11/2025

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