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NPI Code Detail

MEDICARE: JOHN KENNEDY OLSON MD

MEDICARE:   JOHN KENNEDY OLSON  MD
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
1207V00000XObstetrics & Gynecology Physician31645IA

General Provider Information

NPI Number : 1447254081
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN KENNEDY OLSON MD
Provider Business Mailing Address
First Line : 855 A AVE NE
Second Line : P O BOX 3080
City : CEDAR RAPIDS
State : IA
Zip : 52406-3080
Country : US
Telephone Number : 319-368-5500
Fax Number : 319-368-5503
Provider Business Practice Location Address
First Line : 701 10TH ST SE
Second Line : J EDWARD LUNDY PAVILLION 4TH FLOOR
City : CEDAR RAPIDS
State : IA
Zip : 52403-1251
Country : US
Telephone Number : 319-221-8400
Fax Number : 319-221-8403
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2005
Last Update Date : 11/28/2011

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Directions to “ JOHN KENNEDY OLSON MD” Practice Location

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