Provider Demographics
NPI:1265429245
Name:OLK, ROBERT JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:OLK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11710 OLD BALLAS RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7076
Mailing Address - Country:US
Mailing Address - Phone:314-569-2020
Mailing Address - Fax:314-569-1596
Practice Address - Street 1:11710 OLD BALLAS RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7076
Practice Address - Country:US
Practice Address - Phone:314-569-2020
Practice Address - Fax:314-569-1596
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR9531207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180036813 CI6574OtherMEDICARE RAILROAD
MO2498755005OtherCIGNA
MO14566OtherESSENCE
MO201519345Medicaid
MO101062OtherHEALTHLINK
MO106672OtherBLUE SHIELD
MO6739OtherHEALTHCARE USA
MO63192OtherGROUP HEALTH PLAN
MOA13535OtherMERCY HEALTH PLANS
MO008245OtherEXCLUSIVE
MO0882289OtherUNITED HEALTH CARE
MO180027468 CD5617OtherRAILROAD MEDICARE
ILIL4498001OtherIL MEDICARE
MO2498755005OtherCIGNA
MO2498755005OtherCIGNA
MO6739OtherHEALTHCARE USA
MO002012708Medicare ID - Type Unspecified
MO002012708Medicare PIN
MO000094481Medicare PIN