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General NPI Number Information
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NPI Number | 1972510675
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Entity Type | Individual
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Provider Name | RON ANTHON OLSEN DPM
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 03/01/2019
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Provider Practice Location Address
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Address Line | 20185 E OCOTILLO RD STE 105
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-7663
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Country | US
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Telephone | 480-677-3600
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Fax | 480-677-3645
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Provider Business Mailing Address
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Address Line | PO BOX 2240
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-1846
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Country | US
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Telephone | 520-510-3200
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Fax | 480-655-5523
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | AZ0372
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License Number State | AZ
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