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NPI Code Detail

MEDICARE: OLSON FACIAL PLASTIC SURGERY, P.C.

MEDICARE: OLSON FACIAL PLASTIC SURGERY, P.C.
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
1174400000XSpecialist23526AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123526OTHERLICENSE
210776640OTHERCAQH
31881745354OTHERNPI

General Provider Information

NPI Number : 1891975413
Entity Type Code : Organization
Provider Name (Legal Business Name) : OLSON FACIAL PLASTIC SURGERY, P.C.
Provider Business Mailing Address
First Line : PO BOX 64307
Second Line :
City : TUCSON
State : AZ
Zip : 85728-4307
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6340 N CAMPBELL AVE STE 256
Second Line :
City : TUCSON
State : AZ
Zip : 85718-3186
Country : US
Telephone Number : 520-200-2218
Fax Number : 520-200-2935
Authorized Official
Title or Position : OFFICE MANAGER
Name : MERCY OLSON
Credential : RN
Telephone Number : 520-200-2218
Provider Enumeration Date : 11/12/2007
Last Update Date : 12/10/2025

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Directions to “OLSON FACIAL PLASTIC SURGERY, P.C. ” Practice Location

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