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General NPI Number Information
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NPI Number | 1003801929
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Entity Type | Individual
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Provider Name | MARTIN E. OLSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 325 N STATE OF FRANKLIN RD FL 1
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6056
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Country | US
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Telephone | 423-439-7272
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Fax | 423-439-7235
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Provider Business Mailing Address
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Address Line | PO BOX 699
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City | MOUNTAIN HOME
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State | TN
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Zip | 37684-0699
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Country | US
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Telephone | 423-439-7272
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Fax | 423-439-7235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | MD21208
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD21208
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License Number State | TN
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