Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 31325 | KY |
Y | 208600000X | Surgeon | 31325 | KY |
NPI | 1013919273 |
---|---|
Provider Name | Dr. John N Olsofka |
First Address | Louisville, KY 40202-1434 |
Second Address | Louisville, KY 40215-3101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2005 |
Last Update Date | 23/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000050008 | ANTHEM (01) | KY |
020041621 | RAILROAD MEDICARE (01) | KY |
1101115 | PASSPORT (01) | KY |
64313257 | (05) | KY |
G44796 | (02) | KY |
P01026552 | MEDICARE RR (01) | KY |