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NPI Code Detail

MEDICARE: OLIVIA COLLEEN JAMES FUNK PA-C

MEDICARE:   OLIVIA COLLEEN JAMES FUNK  PA-C
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
1363AM0700XMedical Physician Assistant50.006647RXOH

Other Identifiers

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

General Provider Information

NPI Number : 1598370553
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA COLLEEN JAMES FUNK PA-C
Provider Business Mailing Address
First Line : PO BOX 188
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-0188
Country : US
Telephone Number : 740-773-4366
Fax Number :
Provider Business Practice Location Address
First Line : 25716 WILSON ST
Second Line :
City : COOLVILLE
State : OH
Zip : 45723-8153
Country : US
Telephone Number : 740-846-0008
Fax Number : 740-773-4137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2020
Last Update Date : 03/31/2026

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Directions to “ OLIVIA COLLEEN JAMES FUNK PA-C” Practice Location

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