Organization
KEVIN H. OLSEN M.D. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN H OLSEN MD (PRESIDENT)
(570) 558-5558
Entity
Organization
Contact information
Practice address
2603 STAFFORD AVE, SCRANTON, PA 18505-3608
(570) 558-5558
(570) 558-5557
Mailing address
2603 STAFFORD AVENUE, SCRANTON, PA 18505-3608
(570) 558-5558
(570) 558-5557
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD042779E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011413170012
—
PA
Enumeration date
05/29/2007
Last updated
02/14/2008
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