Healthcare Provider Details

I. General information

NPI: 1659357580
Provider Name (Legal Business Name): JAMES H OLSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 SOUTH MC CARRAN BLVD SUITE A-4
RENO NV
89509-6136
US

IV. Provider business mailing address

6630 SOUTH MC CARRAN BLVD SUITE A-4
RENO NV
89509-6136
US

V. Phone/Fax

Practice location:
  • Phone: 775-828-2873
  • Fax: 775-828-2889
Mailing address:
  • Phone: 775-828-2873
  • Fax: 775-828-2889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number9625
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: