Active NPI
Matthew David Olson, PHARMD.
- Pharmacist
- Talihina, OK
National Provider Identifier
1619027802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12577
- Practice address
- One Choctaw Way
Talihina, OK 74571 - Phone
- (918) 567-7000
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12577 | NE | Primary |
Addresses
Primary practice location
One Choctaw Way
Talihina, OK 74571
Mailing address
508 E Miami Ave
McAlester, OK 74501-6424
Phone (402) 203-8463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12577 | NE | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619027802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 E MIAMI AVE",
"city": "MCALESTER",
"state": "OK",
"postal_code": "745016424",
"telephone_number": "402-203-8463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE CHOCTAW WAY",
"city": "TALIHINA",
"state": "OK",
"postal_code": "74571",
"telephone_number": "918-567-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"credential": "PHARMD.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NE",
"license": "12577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Talihina, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.