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General NPI Number Information
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NPI Number | 1407912611
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Entity Type | Organization
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Legal Business Name | ERIC G OLSON, MD
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 21 HAYDEN BRIDGE WAY
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City | SPRINGFIELD
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State | OR
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Zip | 97477-1305
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Country | US
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Telephone | 541-600-2017
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Fax | 541-225-4864
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Provider Business Mailing Address
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Address Line | PO BOX 10605
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City | EUGENE
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State | OR
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Zip | 97440-2605
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | ERIC OLSON
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Credential | MD
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Telephone | 541-600-2017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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