Provider Demographics
NPI:1174807796
Name:OLIVIER, DONALD B
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:B
Last Name:OLIVIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6502 HWY 182 EAST
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380
Mailing Address - Country:US
Mailing Address - Phone:985-384-2126
Mailing Address - Fax:985-384-2120
Practice Address - Street 1:6502 HIGHWAY 182 E
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-2034
Practice Address - Country:US
Practice Address - Phone:985-384-2126
Practice Address - Fax:985-384-2120
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist