Organization
JOHN G OLIVER MD PROFESSIONAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GLADSON OLIVER MD (PRESIDENT)
(336) 838-5121
Entity
Organization
Contact information
Practice address
408 8TH ST, NORTH WILKESBORO, NC 28659-4167
(336) 838-5121
(336) 667-5756
Mailing address
PO BOX 636, NORTH WILKESBORO, NC 28659-0636
(336) 838-5121
(336) 667-5756
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64063
BCBS
NC
05
—
8964063
—
NC
Enumeration date
11/18/2009
Last updated
12/16/2009
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