Provider Demographics
NPI:1295729655
Name:OLIVE, ROBERT JAMES JR (M D)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:OLIVE
Suffix:JR
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:501-321-2663
Mailing Address - Fax:501-321-9705
Practice Address - Street 1:1662 HIGDON FERRY RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6999
Practice Address - Country:US
Practice Address - Phone:501-321-2663
Practice Address - Fax:501-321-9705
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC6517207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR117311001Medicaid
E61802Medicare UPIN
AR200027787OtherRAILROAD MEDICARE
53503Medicare ID - Type Unspecified