=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801376371
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERICAN ONCOLOGY PARTNERS, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/15/2018
-----------------------------------------------------
Last Update Date | 08/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 44055 RIVERSIDE PKWY STE 224
-----------------------------------------------------
City | LANSDOWNE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20176-5177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-858-3110
-----------------------------------------------------
Fax | 703-858-3111
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 749482
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30374-9482
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-963-2100
-----------------------------------------------------
Fax | 813-312-1296
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER / PRESIDENT
-----------------------------------------------------
Name | DR. RYAN K OLSON
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 239-318-9284
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0000X
-----------------------------------------------------
Taxonomy Name | Hematology (Internal Medicine) Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RX0202X
-----------------------------------------------------
Taxonomy Name | Medical Oncology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------