Provider Demographics
NPI:1750178562
Name:OLSON, BYRON CHAPMAN (MD)
Entity type:Individual
Prefix:
First Name:BYRON
Middle Name:CHAPMAN
Last Name:OLSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 TROTTING HORSE LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-5806
Mailing Address - Country:US
Mailing Address - Phone:406-728-6023
Mailing Address - Fax:
Practice Address - Street 1:1430 TROTTING HORSE LN
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-5806
Practice Address - Country:US
Practice Address - Phone:406-728-6023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3673208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology