Individual
JOHN P OLIPHANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3427 STONY SPRING CIR, LOUISVILLE, KY 40220-5437
(502) 493-9994
(502) 493-9991
Mailing address
3427 STONY SPRING CIR, LOUISVILLE, KY 40220-5437
(502) 493-9994
(502) 493-9991
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
30518
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000052171
ANTHEM
—
01
—
1124739
PASSPORT
—
01
—
1200353
UNITED HEALTHCARE
—
Enumeration date
09/08/2005
Last updated
02/24/2009
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