MR. CARL GLENN OLIVER PA NPI 1013903426

NPI Information

  • NPI: 1013903426
  • Provider Name: MR. CARL GLENN OLIVER, PA
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • Address: 502 SUMTER ST
    MONTEZUMA, GA
    ZIP 31063
  • Phone: (478) 472-8178

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NPI Details

MR. Carl Glenn Oliver, PA is a medical physician assistant in Montezuma, GA. MR. Carl Glenn Oliver, PA NPI is 1013903426. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

502 SUMTER ST
MONTEZUMA, GA
ZIP 31063-734
Phone: (478) 472-8178
Fax: (478) 472-3289

The enumeration date for this NPI number is 9/21/2005 and was last updated on 8/17/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical04064GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
197WCFFMMEDICARE PINGEORGIA
2P87969MEDICARE UPIN
3364910OTHERGEORGIAWELLCARE
4455252909AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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