Provider Demographics
NPI:1659357580
Name:OLSON, JAMES H (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H
Last Name:OLSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6630 SOUTH MC CARRAN BLVD
Mailing Address - Street 2:SUITE A-4
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6136
Mailing Address - Country:US
Mailing Address - Phone:775-828-2873
Mailing Address - Fax:775-828-2889
Practice Address - Street 1:6630 SOUTH MC CARRAN BLVD
Practice Address - Street 2:SUITE A-4
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6136
Practice Address - Country:US
Practice Address - Phone:775-828-2873
Practice Address - Fax:775-828-2889
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9625207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002016899Medicaid
NV11041387OtherCAQH
NV002016899Medicaid
NVV37349Medicare ID - Type Unspecified