Provider Demographics
NPI:1023351897
Name:OLLER, DEVIN ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:ARTHUR
Last Name:OLLER
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 1:900 S. LIMESTONE, CTW306
Mailing Address - Street 2:UK DIVISION OF GENERAL INTERNAL MEDICINE
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:830 S. LIMESTONE
Practice Address - Street 2:UK DIVISION OF GENERAL INTERNAL MEDICINE
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-0303
Practice Address - Fax:859-323-1200
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-31
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51551207RA0401X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine