Provider Demographics
NPI:1578539334
Name:O'LEARY, DAVID K (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:K
Last Name:O'LEARY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5066 PINNACLE SQ
Mailing Address - Street 2:STE 106
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3185
Mailing Address - Country:US
Mailing Address - Phone:205-655-3329
Mailing Address - Fax:205-655-3681
Practice Address - Street 1:5066 PINNACLE SQ
Practice Address - Street 2:STE 106
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3185
Practice Address - Country:US
Practice Address - Phone:205-655-3329
Practice Address - Fax:205-655-3681
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-780-TA-242152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALS-780-TA-242OtherAL BOARD OF OPTOMETRY
ALM00718253OtherDEA
ALS-780-TA-242OtherAL BOARD OF OPTOMETRY
ALU44828Medicare UPIN