Individual
JAMES BRIAN OLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2450 E SHOW LOW LAKE RD, SUITE 2A, SHOW LOW, AZ 85901-7953
(928) 537-6767
(928) 537-0299
Mailing address
2450 E SHOW LOW LAKE RD, SUITE 2A, SHOW LOW, AZ 85901-7953
(928) 537-6767
(928) 537-0299
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
ME103523
FL
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
43222
AZ
Other
Enumeration date
05/10/2007
Last updated
06/08/2011
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