Provider Demographics
NPI:1417927401
Name:ERIKSON, NILS SIEGFRIED (MD)
Entity Type:Individual
Prefix:DR
First Name:NILS
Middle Name:SIEGFRIED
Last Name:ERIKSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4207
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75606-4207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2101 W LOOP 281
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-2506
Practice Address - Country:US
Practice Address - Phone:903-315-4422
Practice Address - Fax:903-753-3671
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME892932083A0100X, 207RR0500X
TXP4308207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine