1619945649 NPI number — DR. GEORGIA K OLYMPIO M.D.

Table of content: DR. GEORGIA K OLYMPIO M.D. (NPI 1619945649)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619945649 NPI number — DR. GEORGIA K OLYMPIO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLYMPIO
Provider First Name:
GEORGIA
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619945649
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1899 TATE BLVD SE
Provider Second Line Business Mailing Address:
SUITE 1105
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28602-4200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-322-3821
Provider Business Mailing Address Fax Number:
828-322-6697

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1899 TATE BLVD SE
Provider Second Line Business Practice Location Address:
SUITE 1105
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28602-4200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-322-3821
Provider Business Practice Location Address Fax Number:
828-322-6697
Provider Enumeration Date:
03/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZC0500X , with the licence number:  27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZD0900X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZF0201X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZH0000X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZI0100X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZB0001X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZM0300X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZN0500X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0007X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0101X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0102X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZP0105X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0104X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0213X , with the licence number: 27719 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 220048418 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 8964053 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 64053 . This is a "BCBS OF NORTH CAROLINA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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