| Doctor Name: | MR. JOSEPH EMILIAN OLLIVIER |
| NPI Number: | 1427028067 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHYSICIAN ASSISTANT |
| License Number: | PA-351 |
| Business Practice Address: | 132 5th Ave W Jerome, ID - 833381825 |
| Business Phone Number: | 2083245286 |
| Business Fax Number: | 2083249815 |
| Mailing Address: | 132 5th Ave W, JEROME |
| State: | ID |
| Postal Code: | 833381825 |
| Phone Number: | 2083245286 |
| Fax Number: | 2083249815 |
| NPI Enumeration Date: | 01/25/2006 |
| NPI Last Update Date: | 03/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA-351 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |