Provider Demographics
NPI:1427029875
Name:OLSON, WILLIAM L (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:L
Last Name:OLSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-3166
Mailing Address - Country:US
Mailing Address - Phone:508-583-1066
Mailing Address - Fax:508-580-1423
Practice Address - Street 1:13 WEST STREET
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-3166
Practice Address - Country:US
Practice Address - Phone:508-583-1066
Practice Address - Fax:508-580-1423
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3534152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
9150961OtherCIGNA
726114OtherTUFTS
0030905OtherNEIGHBORHOOD HEALTH PLAN
123637OtherAETNA US HEALTH
2201032OtherUNITED HEALTHCARE
W15854OtherBCBS
S020692OtherCHAMPUS
MA110016369/AMedicaid
1427029875OtherUNICARE
150721OtherHPHC
410041396OtherRAILROAD MEDICARE
MA3534OtherEYE MED VISION CARE
1427029875OtherUNICARE
S020692OtherCHAMPUS
0395260001Medicare NSC