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General NPI Number Information
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NPI Number | 1124976345
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Entity Type | Individual
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Provider Name | PHILIP OLSEN
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Gender |
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Dates
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Enumeration Date | 03/21/2026
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Last Update Date | 03/21/2026
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Provider Practice Location Address
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Address Line | 1199 PRINCE AVE
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City | ATHENS
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State | GA
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Zip | 30606-2797
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Country | US
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Telephone | 706-475-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 345 ASHBROOK LN
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City | ATHENS
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State | GA
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Zip | 30605-3982
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Country | US
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Telephone | 608-575-8621
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Fax |
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 314056
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License Number State | GA
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