Provider Demographics
NPI:1962060558
Name:O'REILLY, OLIVIA CLARE (MD)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:CLARE
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 NE 10TH ST
Mailing Address - Street 2:OUPB 1C
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5417
Mailing Address - Country:US
Mailing Address - Phone:405-271-2663
Mailing Address - Fax:405-271-3074
Practice Address - Street 1:825 NE 10TH ST
Practice Address - Street 2:OUPB 1C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5417
Practice Address - Country:US
Practice Address - Phone:405-271-2663
Practice Address - Fax:405-271-3074
Is Sole Proprietor?:No
Enumeration Date:2019-05-30
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-11602207X00000X
OK46106207X00000X, 207XX0005X
NCRTL24-0190207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine