Provider Demographics
NPI:1922278373
Name:ARTHUR W. ERICKSON, OD, PC
Entity Type:Organization
Organization Name:ARTHUR W. ERICKSON, OD, PC
Other - Org Name:STERLING OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:W
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:701-852-3762
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:
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-01
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND603152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND168333OtherEYEMED
NDDC5304OtherRR MEDICARE
ND801784OtherND VSI
ND05608OtherBCBS ND
ND60562Medicaid
NDDC5304OtherRR MEDICARE
ND168333OtherEYEMED
NDX72698Medicare UPIN