Provider Demographics
NPI:1720824113
Name:SCHOLES, OLIVIA ELYSE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ELYSE
Last Name:SCHOLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:ELYSE
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:404 W MILL ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:WI
Mailing Address - Zip Code:54479-9797
Mailing Address - Country:US
Mailing Address - Phone:435-213-6317
Mailing Address - Fax:
Practice Address - Street 1:611 N SAINT JOSEPH AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-1832
Practice Address - Country:US
Practice Address - Phone:866-520-2510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101092851208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics