Individual
DR. CHRISTOPHER P OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
301 W MONROE ST, MT PLEASANT, IA 52641-2112
(319) 385-9534
Mailing address
301 W MONROE ST, MT PLEASANT, IA 52641-2112
(319) 385-9534
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01860
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010761565
CHAMPUS REG8 PROVIDER#
IA
05
—
1254169
—
IA
01
—
25416
BCBS IA PROVIDER NUMBER
IA
01
—
P00759633
RR MEDICARE PROVIDER NUMBER
IA
Enumeration date
12/06/2006
Last updated
01/02/2017
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