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NPI Code Detail

MEDICARE: JILL ALLISON OLIVER M.D.

MEDICARE: JILL ALLISON OLIVER M.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
1207Q00000XFamily Medicine Physician127463NV
2207Q00000XFamily Medicine Physician11484NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111484OTHERNV STATE BOARD OF MED EX
2127463OTHERNVABFM

General Provider Information

NPI Number : 1649218744
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL ALLISON OLIVER M.D.
Provider Business Mailing Address
First Line : 5990 S RAINBOW BLVD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-4203
Country : US
Telephone Number : 702-568-5660
Fax Number : 702-568-5661
Provider Business Practice Location Address
First Line : 5990 S RAINBOW BLVD STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-4203
Country : US
Telephone Number : 702-568-5660
Fax Number : 702-568-5661
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2006
Last Update Date : 09/13/2023

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