Individual
LARRY DEAN OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
940 N MARR RD, SUITE C, COLUMBUS, IN 47201-2610
(812) 376-9353
(812) 376-3757
Mailing address
940 N MARR RD, SUITE C, COLUMBUS, IN 47201-2610
(812) 376-9353
(812) 376-3757
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
1029948
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000195463
ANTHEM
IN
05
—
100323370
—
IN
01
—
200040852
RAILROAD MEDICARE
IN
01
—
SIHO
003682
IN
Enumeration date
07/03/2006
Last updated
01/04/2010
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