Provider Demographics
NPI:1326575317
Name:OLSON, TYLER STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:STEVEN
Last Name:OLSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TYLER
Other - Middle Name:STEVEN
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9255
Mailing Address - Fax:515-875-9223
Practice Address - Street 1:5501 NW 86TH ST STE 300
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1810
Practice Address - Country:US
Practice Address - Phone:515-875-9035
Practice Address - Fax:515-875-9036
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-10868207Q00000X
IAMD-45422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine