Olson, Jared Craig
Olson, Jared Craig is an sole proprietor health care provider with primary practice located at 1711 E 20Th St , Farmington NM 87401-4309. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Olson, Jared Craig can be contacted via phone (505) 326-4080.Contact Information
Primary practice address
1711 E 20Th St
Farmington NM 87401-4309
Phone: (505) 326-4080
Fax: (505) 326-4260
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 569 NM | New Mexico |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT 12848 | California |
Profile Details
| NPI number | 1386775070 |
|---|---|
| LBN Legal business name | Olson, Jared Craig |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 7th, 2007 |
| Last updated | Jan 17th, 2012 - about 12 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 | 1386775070 | NPPES |
| New Mexico | MEDICAID | 34759077 |
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