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Organization

RANDALL L. OLIVER, M.D., P.C.

Active
Other names
OLIVER HEADACHE AND PAIN CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
RANDALL LEE OLIVER M.D. (OWNER/PHYSICIAN)
(812) 477-7246
Entity
Organization

Contact information

Practice address
1101 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8016
(812) 477-7246
(812) 477-7240
Mailing address
PO BOX 6810, EVANSVILLE, IN 47719-0810
(812) 477-7246
(812) 477-7240

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000386753
ANTHEM PAIN MGMT
IN
01
000000089152
ANTHEM FAMILY PRACTICE
IN
05
100180970A
IN
01
1006173
CHAMPUS
IN
01
10643
HEALTHSOURCE
IN
01
169425
HEALTHLINK
IN
05
64872484
KY
01
659100
PRINCIPAL
IN
01
719364
AFFORDABLE
IN
Enumeration date
07/03/2006
Last updated
03/19/2013
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