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Individual

RICHARD C OLIPHANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
950 BRECKENRIDGE LN STE 200, LOUISVILLE, KY 40207-5929
(502) 893-6777
(502) 899-5535
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 489-6613
(502) 489-5751

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01034138
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
21599
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000247137
ANTHEM
01
50000076
PASSPORT
05
64215999
KY
Enumeration date
08/10/2005
Last updated
02/19/2019
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