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NPI Code Detail

MEDICARE: GERALD E OLSON O.D.

MEDICARE: GERALD E OLSON O.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
1152W00000XOptometristOEG00748PA

General Provider Information

NPI Number : 1619979549
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALD E OLSON O.D.
Provider Business Mailing Address
First Line : 506 ATHENA DR
Second Line :
City : DELMONT
State : PA
Zip : 15626-1005
Country : US
Telephone Number : 724-468-6869
Fax Number : 724-468-6207
Provider Business Practice Location Address
First Line : 2001 LINCOLN WAY STE 240
Second Line :
City : WHITE OAK
State : PA
Zip : 15131-2419
Country : US
Telephone Number : 412-673-1243
Fax Number : 412-673-1129
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 06/03/2019

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