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General NPI Number Information
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NPI Number | 1942281027
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Entity Type | Individual
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Provider Name | LARRY TODD OLSEN DO
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Gender | Male
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Dates
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Enumeration Date | 11/07/2005
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Last Update Date | 02/11/2015
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Provider Practice Location Address
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Address Line | 3400 S DOUGLAS BLVD 302
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City | OKLAHOMA CITY
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State | OK
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Zip | 73150
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Country | US
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Telephone | 405-733-8000
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Fax | 405-733-7820
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Provider Business Mailing Address
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Address Line | 3400 S DOUGLAS BLVD 302
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City | OKLAHOMA CITY
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State | OK
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Zip | 73150
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Country | US
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Telephone | 405-733-8000
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Fax | 405-733-7820
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4132
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License Number State | OK
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