Provider Demographics
NPI:1346412608
Name:AXEL K OLSON MD PC
Entity Type:Organization
Organization Name:AXEL K OLSON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AXEL
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:AXEL K OLSON, M D
Authorized Official - Phone:205-536-7600
Mailing Address - Street 1:3686 GRANDVIEW PKWY STE 750
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3409
Mailing Address - Country:US
Mailing Address - Phone:205-536-7600
Mailing Address - Fax:205-203-4491
Practice Address - Street 1:3686 GRANDVIEW PKWY STE 750
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3409
Practice Address - Country:US
Practice Address - Phone:205-536-7600
Practice Address - Fax:205-203-4491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13077133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty