Provider Demographics
NPI:1164641072
Name:OLSON-GAREWAL, J. KRISTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:J.
Middle Name:KRISTIN
Last Name:OLSON-GAREWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 S 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85701-2467
Mailing Address - Country:US
Mailing Address - Phone:520-444-7676
Mailing Address - Fax:
Practice Address - Street 1:537 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-2467
Practice Address - Country:US
Practice Address - Phone:520-444-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12966207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FO3707998OtherDEA