Individual
DR. JASON S OLIPHANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2551 E VISTOSO COMMERCE LOOP, ORO VALLEY, AZ 85755-9124
(520) 545-1966
Mailing address
12995 N ORACLE RD, TUCSON, AZ 85739-9528
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
44153
AZ
2085R0202X
Diagnostic Radiology Physician
Primary
44153
AZ
2085U0001X
Diagnostic Ultrasound Physician
44153
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396839957
PHYSICIAN INDIVIDUAL NPI
AZ
05
—
600935
—
AZ
01
—
P00921777
PHYSICIAN INDIVIDUAL MEDICARE RAILROAD PTAN
AZ
Enumeration date
10/03/2006
Last updated
08/03/2021
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