Individual
DR. JEROLD J. OLSON
Active
Individual
DR. JEROLD J. OLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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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