MEDICARE: DR. JESSICA ELIZABETH OLIVER MD

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
1	207WX0009X	Glaucoma Specialist (Ophthalmology) Physician	0101226841	VA
2	207W00000X	Ophthalmology Physician	0101226841	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134105455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA ELIZABETH OLIVER MD

Provider Business Mailing Address
First Line	:	6231 LEESBURG PIKE
Second Line	:	SUITE 608
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2102
Country	:	US
Telephone Number	:	703-534-3900
Fax Number	:	703-536-3729

Provider Business Practice Location Address
First Line	:	6231 LEESBURG PIKE
Second Line	:	SUITE 608
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2102
Country	:	US
Telephone Number	:	703-534-3900
Fax Number	:	703-536-3729

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	07/06/2017

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