Individual provider · Type 1 NPI

Kenneth Michael Olson, P.A. - C

Medical Physician Assistant · St. Louis, MO

NPI number 1649232877 Active

Practice location

915 N Grand Blvd, 11F/JC St. Louis Va
St. Louis, MO 63106-1621

Call (314) 652-4100 Map

Mailing address

840 Castleaire Pkwy
St. Louis, MO 63129-2049

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1649232877

Kenneth Michael Olson, P.A. - C's National Provider Identifier is 1649232877, issued on Apr 4, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in St. Louis, MO. The record was last updated on Jul 13, 2026.