Healthcare Provider Details

I. General information

NPI: 1396952479
Provider Name (Legal Business Name): DARON E. OLMSTED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DARON E. OLMSTED D.O.

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E 14TH ST
SEDALIA MO
65301-5972
US

IV. Provider business mailing address

601 E 14TH ST
SEDALIA MO
65301-5972
US

V. Phone/Fax

Practice location:
  • Phone: 660-826-8833
  • Fax:
Mailing address:
  • Phone: 660-826-8833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2018013281
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number47546
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number20A12881
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberN9395
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: