Healthcare Provider Details

I. General information

NPI: 1588788749
Provider Name (Legal Business Name): LARRY A. OLNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 SPARROW NEST POINT
SAINT HELENA ISLAND SC
29920
US

IV. Provider business mailing address

11 SPARROW NEST POINT
SAINT HELENA ISLAND SC
29920
US

V. Phone/Fax

Practice location:
  • Phone: 843-838-9953
  • Fax:
Mailing address:
  • Phone: 843-838-9953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number41097
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD2005-0702
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: