Individual
JEREMI THOMAS OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
700 S PARK ST, DEAN ST. MARY'S OUTPATIENT CENTER, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-7975
Mailing address
700 S PARK ST, DEAN ST. MARY'S OUTPATIENT CENTER, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-7975
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
1489-023
WI
363AS0400X
Surgical Physician Assistant
Primary
1489-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41966100
—
WI
01
—
60570
DEAN HEALTH INSURANCE
WI
Enumeration date
10/03/2005
Last updated
04/15/2009
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