Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACK DALE TOLLIVER JR., M.D.
Active Sole ProprietorDR. JACK DALE TOLLIVER JR., M.D. is a Legal Medicine healthcare provider located in LOUISVILLE, Kentucky. NPI 1891155024 is currently active in the NPPES registry. Verify at CMS.
Legal Medicine · LOUISVILLE, KY
Registration Details
- NPI Number
- 1891155024
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 1, 2016 (10.482311584004 yrs)
- Last Updated
- Mar 1, 2016
- License
-
21479 (KY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2120 CAVE SPRING PLLOUISVILLE, KY, 402231562Browse KY providers · Browse ZIP 40223
- Phone
- 5029311373
- Primary Specialty
-
Legal Medicine
173000000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.