Healthcare Provider Details

I. General information

NPI: 1144472903
Provider Name (Legal Business Name): BRANDON REED ERICKSON MD, FACS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2008
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 LIBERTY ST SE
SALEM OR
97302-4245
US

IV. Provider business mailing address

1309 LIBERTY ST SE
SALEM OR
97302-4245
US

V. Phone/Fax

Practice location:
  • Phone: 503-585-2022
  • Fax: 503-378-0797
Mailing address:
  • Phone: 503-585-2022
  • Fax: 503-378-0797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD197672
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: