Provider Demographics
NPI:1003047853
Name:OLSON, GARRET CARL (DO)
Entity Type:Individual
Prefix:
First Name:GARRET
Middle Name:CARL
Last Name:OLSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 W BOISE CIR
Mailing Address - Street 2:ST JOHN OWASSO - EMERGENCY DEPT
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-4900
Mailing Address - Country:US
Mailing Address - Phone:918-994-8000
Mailing Address - Fax:918-994-8497
Practice Address - Street 1:1000 W BOISE CIR
Practice Address - Street 2:ST JOHN OWASSO - EMERGENCY DEPT
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-4900
Practice Address - Country:US
Practice Address - Phone:918-994-8000
Practice Address - Fax:918-994-8497
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4796207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine