MEDICARE: DR. TIMOTHY O'LEARY O.D.

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
1	152W00000X	Optometrist	3748 -- T582	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000017763	OTHER	OH	BLUE CROSS-BLUE SHIELD
2	374802	OTHER	OH	HUMANA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356428791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY O'LEARY O.D.

Provider Business Mailing Address
First Line	:	1233 HERSCHEL WOODS LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-4335
Country	:	US
Telephone Number	:	513-321-2015
Fax Number	:	513-321-8732

Provider Business Practice Location Address
First Line	:	1233 HERSCHEL WOODS LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45208-4335
Country	:	US
Telephone Number	:	513-321-2015
Fax Number	:	513-321-8732

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	12/18/2013

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