Individual
DR. JEROLD J. OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7418 N LA CHOLLA BLVD, TUCSON, AZ 85741-2306
(520) 731-1110
(520) 731-6582
Mailing address
PO BOX 64307, TUCSON, AZ 85728-4307
(520) 577-9783
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
23526
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004337570
AETNA
AZ
01
—
1Z6468
HEALTHNET
AZ
01
—
322206001
APIPA
AZ
01
—
32220602
HEALTHCHOICE
AZ
01
—
470895687
UNITED HEALTH CARE
AZ
01
—
470895687-00
INDIAN HEALTH
AZ
01
—
47089568700
PACIFICARE
AZ
01
—
47089568785718A001
TRICARE
AZ
01
—
AZ0724550
BCBS
AZ
01
—
P00010045
RR MEDICARE
AZ
Enumeration date
01/12/2007
Last updated
08/22/2013
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