DR. OLIVER GREY WALDROP MD NPI 1205879475

NPI Information

NPI: 1205879475
Provider Name: DR. OLIVER GREY WALDROP, MD
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Organization: HONORHEALTH AMBULATORY

PECOS Registration: Yes

Address:
26224 N TATUM BLVD STE 5
PHOENIX, AZ
ZIP 85050
Phone: (480) 882-7580
Get Directions

DR. Oliver Grey Waldrop, MD is a student in an organized health care education training program in Phoenix, AZ with 21 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Oliver Grey Waldrop, MD NPI is 1205879475. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduation Year:2003

The provider's business location address is:

26224 N TATUM BLVD STE 5
PHOENIX, AZ
ZIP 85050-500
Phone: (480) 882-7580
Fax: (480) 563-7442

The NPI 1205879475 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/14/2006 and was last updated on 11/27/2020.

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	License Number	License State	Primary
1	207Q00000X	Family Medicine	46900	ARIZONA	No
2	207Q00000X	Family Medicine	1047846583	MISSISSIPPI	No
3	208M00000X	Hospitalist	18958	MISSISSIPPI	No
4	390200000X	Student in an Organized Health Care Education/Training Program	46900	ARIZONA	Yes

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
1	P00462351	OTHER	MISSISSIPPI	RAILROAD MEDICARE
2	02886714	MEDICAID	MISSISSIPPI
3	033328	MEDICAID	ARIZONA

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: 11/14/2023

NPI Synchronization or Removal

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