Individual
JEFFREY R OLIVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
610 30TH AVE WEST, ALEXANDRIA CLINIC, ALEXANDRIA, MN 56308
(320) 763-5123
(320) 763-7883
Mailing address
610 30TH AVE WEST, ALEXANDRIA CLINIC, ALEXANDRIA, MN 56308
(320) 763-5123
(320) 763-7883
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
37198
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
913330500
—
MN
01
—
P00097984
RR MEDICARE
MN
Enumeration date
01/18/2006
Last updated
11/12/2014
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