Individual
DR. JASON LEE OLIPHANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1211 UNION AVE, SUITE 200, MEMPHIS, TN 38104-6638
(901) 260-8551
(901) 260-8590
Mailing address
2595 CENTRAL AVE, MEMPHIS, TN 38104-5905
(901) 260-8551
(901) 260-8590
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301088440
MI
208600000X
Surgery Physician
Primary
47275
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1523676
—
TN
Enumeration date
05/17/2007
Last updated
03/12/2012
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