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NPI Code Detail

MEDICARE: MICHAEL PHILLIP OLIVER

MEDICARE: MICHAEL PHILLIP OLIVER
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
11041C0700XClinical Social Worker10161-CAR
21041C0700XClinical Social WorkerC9757MS
31041C0700XClinical Social WorkerLSW0000007372TN

General Provider Information

NPI Number : 1649521436
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL PHILLIP OLIVER
Provider Business Mailing Address
First Line : 4711 NARCISSUS DR
Second Line :
City : BARTLETT
State : TN
Zip : 38135-1492
Country : US
Telephone Number : 615-810-8180
Fax Number :
Provider Business Practice Location Address
First Line : 4455 ALLEN LN STE 130
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-2208
Country : US
Telephone Number : 702-385-1072
Fax Number : 702-385-3053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2012
Last Update Date : 09/08/2022

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Directions to “ MICHAEL PHILLIP OLIVER ” Practice Location

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