Healthcare Provider Details

I. General information

NPI: 1346881182
Provider Name (Legal Business Name): NEVADA SPINAL AND ORTHOPEDIC SURGERY, DR OLSON LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2019
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 S MCCARRAN BLVD STE A4
RENO NV
89509-6136
US

IV. Provider business mailing address

PO BOX 34120
RENO NV
89533-4120
US

V. Phone/Fax

Practice location:
  • Phone: 775-722-9854
  • Fax:
Mailing address:
  • Phone: 775-747-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES OLSON
Title or Position: PRESIDENT
Credential: MD
Phone: 775-722-9854