Provider Demographics
NPI:1205032281
Name:OLIPHANT, SALLIE SHERROD (MD)
Entity Type:Individual
Prefix:DR
First Name:SALLIE
Middle Name:SHERROD
Last Name:OLIPHANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5 SAINT VINCENT CIR STE 300
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5417
Mailing Address - Country:US
Mailing Address - Phone:501-552-8800
Mailing Address - Fax:501-552-5343
Practice Address - Street 1:5 SAINT VINCENT CIR STE 300
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-552-8800
Practice Address - Fax:501-552-5343
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7982207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR299298YJJGMedicare PIN