Individual
DR. ANGELA SUZZANNE OLOMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO, FACN
Contact information
Practice address
900 E SAN MARTIN ST, BOLIVAR, MO 65613-2893
(417) 326-7272
(417) 326-2193
Mailing address
PO BOX 49, BOLIVAR, MO 65613-0049
(417) 326-7272
(417) 326-2193
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R1J41
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
242734010
—
MO
05
—
242734036
—
MO
01
—
MA3677001
MEDICARE PTAN
MO
01
—
P00230684
RAILROAD MC ID #
MO
Enumeration date
04/12/2006
Last updated
07/23/2025
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