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NPI Code Detail

MEDICARE: THOMAS HARRY OLSON M.D.

MEDICARE: THOMAS HARRY OLSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2237SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20001211OTHERSDBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1134127087
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS HARRY OLSON M.D.
Provider Business Mailing Address
First Line : PO BOX 277
Second Line :
City : VERMILLION
State : SD
Zip : 57069-0277
Country : US
Telephone Number : 605-624-5666
Fax Number : 605-624-2984
Provider Business Practice Location Address
First Line : 1330 E MAIN ST
Second Line :
City : VERMILLION
State : SD
Zip : 57069-0277
Country : US
Telephone Number : 605-624-5666
Fax Number : 605-624-2984
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 05/09/2008

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