Raleigh G. O'Leary, IDMT
Individual provider Active NPI Independent Duty Medical Technicians · Moody Afb, GA
NPI 1972213320 · NPPES record last updated Nov 28, 2022
Key facts
- NPI
- 1972213320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 3278 Mitchell Blvd BLDG 900
Moody Afb, GA 31699-1500 - Phone
- (229) 257-1347
- NPI assigned
- Nov 28, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
3278 Mitchell Blvd BLDG 900
Moody Afb, GA 31699-1500
Mailing address
3278 Mitchell Blvd BLDG 900
Moody Afb, GA 31699-1500
Other providers in Moody Afb, GA
- Colin Michael Mullaly
- Taylor Murrie-Robinson
- Cory Newby
- Gaddiel Nieves
- Robert Niewoonder
- Jafet A Ojeda Rodriguez
- Samuel Dewayne Oldham
- Georgia Georgetta Oropeza
- Jessica Lynn Otto
- Jennifer Paccassi
All providers in Moody Afb, GA · Independent Duty Medical Technicians in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.