Healthcare Provider Details

I. General information

NPI: 1043163876
Provider Name (Legal Business Name): OLIVER FAMILY MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 KADERLY ST NW STE A
NEW PHILADELPHIA OH
44663-1242
US

IV. Provider business mailing address

1417 KADERLY ST NW STE A
NEW PHILADELPHIA OH
44663-1242
US

V. Phone/Fax

Practice location:
  • Phone: 330-422-3577
  • Fax: 330-230-2969
Mailing address:
  • Phone: 330-422-3577
  • Fax: 330-230-2969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOSEPH DEAN OLIVER
Title or Position: CO-OWNER
Credential: CNP
Phone: 330-340-9147