Olson, Jacob B
Olson, Jacob B is an sole proprietor health care provider with primary practice located at 105 S Willow Ave , Cookeville TN 38501-4667. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Olson, Jacob B can be contacted via phone (931) 526-9518.Contact Information
Primary practice address
105 S Willow Ave
Cookeville TN 38501-4667
Phone: (931) 526-9518
Fax: (931) 372-0087
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | PA03726 | Tennessee |
Profile Details
| NPI number | 1922582873 |
|---|---|
| LBN Legal business name | Olson, Jacob B |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 17th, 2018 |
| Last updated | Oct 10th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922582873 | NPPES |
| Tennessee | MEDICAID | Q047209 |
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