Provider Demographics
NPI:1124116017
Name:OLIVER, JAMES COLLIS (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:COLLIS
Last Name:OLIVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-1114
Mailing Address - Country:US
Mailing Address - Phone:864-235-1115
Mailing Address - Fax:
Practice Address - Street 1:9 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-1114
Practice Address - Country:US
Practice Address - Phone:864-235-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12589207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine