Healthcare Provider Details

I. General information

NPI: 1194909424
Provider Name (Legal Business Name): BYRON & DAUGHTERS DBA, CRAIG B OLSON, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2007
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 N WILLOW ST
HARRISON AR
72601-2994
US

IV. Provider business mailing address

PO BOX 1893
MOUNTAIN HOME AR
72654-1893
US

V. Phone/Fax

Practice location:
  • Phone: 870-365-2244
  • Fax: 870-365-2438
Mailing address:
  • Phone: 870-424-7070
  • Fax: 870-424-6616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberE3017
License Number StateAR

VIII. Authorized Official

Name: DR. CRAIG B OLSON
Title or Position: PRESIDENT
Credential: MD
Phone: 870-365-2244