# MR. JOSEPH EMILIAN OLLIVIER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1427028067
- **Gender:** Man
- **Credential:** PHYSICIAN ASSISTANT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA351 | ID | Yes |
| 363AM0700X | Medical Physician Assistant | PA-351 | ID | — |

## Other

- **Enumeration date:** 01/25/2006
- **Last updated:** 08/17/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000010032406 | BLUE SHIELD OF IDAHO | ID |
| 01 | — | 000010032407 | BLUE SHIELD OF IDAHO | ID |
| 01 | — | 085960 | BLUE SHIELD | ID |
| 05 | — | 806032100 | — | ID |
| 05 | — | 806032101 | — | ID |
| 01 | — | 820227163G040 | TRICARE | ID |
| 01 | — | PA351 | BLUE CROSS OF IDAHO | ID |
| 01 | — | PAIM4 | BLUE CROSS OF IDAHO | ID |