Provider Demographics
NPI:1356533392
Name:STOBART, OLGA V (MD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:V
Last Name:STOBART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1046 6TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321-1916
Mailing Address - Country:US
Mailing Address - Phone:541-967-4160
Mailing Address - Fax:541-928-2942
Practice Address - Street 1:1046 6TH AVE SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-1916
Practice Address - Country:US
Practice Address - Phone:541-967-4160
Practice Address - Fax:541-928-2942
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27712207R00000X
WAMD60741667207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine