Olson, Jay R

Olson, Jay R is an individual health care provider with primary practice located at 12511 Wayzata Blvd Ridgedale Center, Minnetonka MN 55305-1938. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Olson, Jay R can be contacted via phone (952) 591-1970.

Contact Information

Primary practice address
12511 Wayzata Blvd Ridgedale Center Minnetonka MN 55305-1938
Fax: (952) 591-1972
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2325 Minnesota

Profile Details

NPI number 1326072752
LBN Legal business name Olson, Jay R
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Jan 30th, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326072752 NPPES
Minnesota MEDICAID 222141100

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