Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 46315 | CO |
Y | 2080P0214X | Pediatric Pulmonologist | 46315 | CO |
NPI | 1215083837 |
---|---|
Provider Name | James T. Olin |
First Address | Denver, CO 80206-2761 |
Second Address | Denver, CO 80206-2761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 17/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
97121550 | (05) | CO |