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General NPI Number Information
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NPI Number | 1750876645
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Entity Type | Individual
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Provider Name | KRISTOFOR AKSAMIT OLSON MD, PHD
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Gender | Male
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | LOGAN HEALTH SURGICAL CLINIC 1333 SURGICAL SERVICES DRIVE
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City | KALISPELL
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State | MT
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Zip | 59901
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Country | US
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Telephone | 406-751-5392
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 RED RIVER ST
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City | AUSTIN
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State | TX
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Zip | 78701-1918
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Country | US
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Telephone | 512-324-7392
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | MED-PHYS-LIC-161323
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MED-PHYS-LIC-161323
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A186420
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License Number State | CA
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