P Praxis·MD
● Active Type 1 · Individual

MR. Carl Glenn Oliver, PA

Physician Assistant·Montezuma, GA· NPI 1013903426 · Enumerated 2005 · 20 years on NPI
Oliver is 1 of 1 physician assistant providers in Montezuma and 1 of 1333 in Georgia.
NPI age
20 years
Enumerated 2005-09-21
Primary specialty
Physician Assistant
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2016-08-17
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 1333 active physician assistant providers in Georgia.

NPI age
20 years
↑ 5 yr above median (15 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
0
21% of peers hold subspecialties

NPI lifetime · 2005 → 2026

2005-09Enumerated in NPPES
2005 2026

Where they practice

Practice location
502 Sumter St
Montezuma, GA 310631734
📞 4784728178fax 4784723289
Mailing address
502 Sumter St
Montezuma, GA 310631734
📞 4784728178fax 4784723289

Specialties

  • Physician Assistant Primary
    Definition to come...
    GA license #04064 taxonomy 363AM0700X

Identifiers

TypeValueNotes
05 (GA) 455252909A
01 (GA) 364910 WELLCARE

Practice context

Part of a multi-provider practice. 7 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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