Individual
DR. JOHN P OLSON
Active
Individual
DR. JOHN P OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
102486
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100177320B
—
KS
01
—
140006377
RR MEDICARE
MO
05
—
207918228
—
MO
Enumeration date
07/07/2006
Last updated
11/27/2017
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