MEDICARE: LARRY A. OLNEY 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
1	174400000X	Specialist	41097	MA
2	174400000X	Specialist	MD2005-0702	NM

General Provider Information

NPI Number	:	1588788749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY A. OLNEY M.D.

Provider Business Mailing Address
First Line	:	11 SPARROW NEST POINT
Second Line	:
City	:	SAINT HELENA ISLAND
State	:	SC
Zip	:	29920
Country	:	US
Telephone Number	:	843-838-9953
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 SPARROW NEST POINT
Second Line	:
City	:	SAINT HELENA ISLAND
State	:	SC
Zip	:	29920
Country	:	US
Telephone Number	:	843-838-9953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	09/11/2025

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