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Individual

DR. MARK DUANE OLMSTED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
117 E LINCOLN AVE, FERGUS FALLS, MN 56537-2216
(218) 736-7555
(218) 739-6586
Mailing address
117 E LINCOLN AVE, FERGUS FALLS, MN 56537-2216
(218) 736-7555
(218) 739-6586

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2099
MN
152W00000X
Optometrist
2141
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1010283
PREFERRED ONE
MN
05
119523900
MN
01
2200947
MEDICA
MN
01
410049146
RAILROAD MEDICARE
MN
01
47845OL
BLUE CROSS BLUE SHIELD
MN
05
60615
ND
Enumeration date
06/02/2006
Last updated
06/26/2008
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