Provider Demographics
NPI:1730366436
Name:DR MICHAEL O'REILLY & ASSOCIATES LLC
Entity type:Organization
Organization Name:DR MICHAEL O'REILLY & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-645-9780
Mailing Address - Street 1:PO BOX 13416
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44334-8816
Mailing Address - Country:US
Mailing Address - Phone:330-805-5111
Mailing Address - Fax:
Practice Address - Street 1:2887 S ARLINGTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-4715
Practice Address - Country:US
Practice Address - Phone:330-645-9560
Practice Address - Fax:330-645-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3192152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2919837Medicaid
OH9373991Medicare PIN
OH2919837Medicaid