Provider Demographics
NPI:1396745303
Name:OLINGER, JILL M (MD)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:M
Last Name:OLINGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 RIVERS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-6048
Mailing Address - Country:US
Mailing Address - Phone:828-406-1485
Mailing Address - Fax:
Practice Address - Street 1:815 SW BOND ST
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702
Practice Address - Country:US
Practice Address - Phone:541-382-2811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000044278207N00000X
AZ65971207N00000X
WAMD60668630207N00000X
ORMD182503207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3380668OtherMEDICARE GROUP
ORMD182503OtherLICENSE
TN4207351OtherBCBS
TN5988393OtherCIGNA
I41478Medicare UPIN