Provider Demographics
NPI:1710948872
Name:ERICKSON, ARTHUR W (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:W
Last Name:ERICKSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 20TH ST NW
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-1759
Mailing Address - Country:US
Mailing Address - Phone:701-852-3762
Mailing Address - Fax:
Practice Address - Street 1:3220 S BROADWAY STE C
Practice Address - Street 2:STERLING OPTICAL
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-7332
Practice Address - Country:US
Practice Address - Phone:701-852-5200
Practice Address - Fax:701-837-0475
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND603152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND60562Medicaid
ND168333OtherEYEMED
ND352016OtherNVA
ND410049049OtherRAILROAD MEDICARE
ND731645038OtherTRICARE
ND892756OtherND VSI
ND22017OtherBCBS OF ND
ND892756OtherND VSI
ND22017Medicare ID - Type Unspecified