MEDICARE: KENNETH W OLANDER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	029068	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	180029273	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0189280	OTHER	CIGNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0840032	OTHER	UNITED HEALTHCARE
4	4016420	OTHER	AETNA
6	3063767	OTHER	BLUE CROSS BLUE SHIELD
7	100023403	OTHER	PHP
8	3333333	OTHER	UMWA
9	TN0112	OTHER	JOHN DEERE

General Provider Information

NPI Number	:	1568431393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH W OLANDER M.D.

Provider Business Mailing Address
First Line	:	1928 ALCOA HWY
Second Line	:	SUITE 324
City	:	KNOXVILLE
State	:	TN
Zip	:	37920-1502
Country	:	US
Telephone Number	:	865-524-9871
Fax Number	:	865-305-6695

Provider Business Practice Location Address
First Line	:	622 SMITHVIEW DR
Second Line	:
City	:	MARYVILLE
State	:	TN
Zip	:	37803-6100
Country	:	US
Telephone Number	:	865-681-1234
Fax Number	:	865-982-9746

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	05/09/2008

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Directions to “ KENNETH W OLANDER M.D.” Practice Location

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