Individual
DR. LINDA OLSON DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
W1046 MARIETTA AVE, SUITE 230, IXONIA, WI 53036-9498
(920) 206-6310
(920) 206-6948
Mailing address
W1046 MARIETTA AVE, SUITE 230, IXONIA, WI 53036-9498
(920) 206-6310
(920) 206-6948
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38840
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000216D
HUMANA
—
05
—
32349600
—
WI
Enumeration date
05/13/2006
Last updated
08/27/2013
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