Provider Demographics
NPI:1558688697
Name:OLSSON, ERIK CHRISTIAN ANDERS
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:CHRISTIAN ANDERS
Last Name:OLSSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 E BARNETT RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8225
Mailing Address - Country:US
Mailing Address - Phone:541-779-5007
Mailing Address - Fax:541-779-5022
Practice Address - Street 1:1311 E BARNETT RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8225
Practice Address - Country:US
Practice Address - Phone:541-779-5007
Practice Address - Fax:541-779-5022
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2016-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD175886207XS0117X
PAMD453311207XS0117X
NJ25MA09674100207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine