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General NPI Number Information
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NPI Number | 1184613101
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Entity Type | Individual
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Provider Name | LOREN A OLSON M.D., D.L.F.A.P.A.
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Gender | Male
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 4908 FRANKLIN AVE
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City | DES MOINES
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State | IA
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Zip | 50310-1901
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Country | US
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Telephone | 515-280-4930
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Fax | 515-309-0686
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Provider Business Mailing Address
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Address Line | 2213 GRAND AVE
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City | DES MOINES
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State | IA
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Zip | 50312-5305
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Country | US
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Telephone | 515-237-3974
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Fax | 515-883-2692
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 21941
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2021003893
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License Number State | MO
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