Provider Demographics
NPI:1992864037
Name:OLSON, CHRISTOPHER P (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:P
Last Name:OLSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2112
Mailing Address - Country:US
Mailing Address - Phone:319-385-9534
Mailing Address - Fax:
Practice Address - Street 1:301 W MONROE ST
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2112
Practice Address - Country:US
Practice Address - Phone:319-385-9534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01860152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00759633OtherRR MEDICARE PROVIDER NUMBER
IA1254169Medicaid
IA010761565OtherCHAMPUS REG8 PROVIDER#
IA25416OtherBCBS IA PROVIDER NUMBER
IAT01441Medicare UPIN
IA4698120001Medicare ID - Type UnspecifiedDMER REGD PROVIDER NUMBER
IAP00759633OtherRR MEDICARE PROVIDER NUMBER