# GORDON S OLSEN, DO PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922297324
- **Authorized official:** GORDON S. OLSEN D.O. (ORTHOPEDIC SURGEON)
- **Authorized official phone:** (435) 654-6360

## Contact information

- **Practice address:** 1485 S HIGHWAY 40, HEBER CITY, UT 84032-3522
- **Practice address phone:** (435) 654-6360
- **Practice address fax:** (435) 657-0294
- **Mailing address:** PO BOX 796, HEBER CITY, UT 84032-0796
- **Mailing address phone:** (435) 654-6360
- **Mailing address fax:** (435) 654-0805

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | UT | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | — | UT | — |

## Other

- **Enumeration date:** 10/22/2007
- **Last updated:** 05/07/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 520192386001 | — | UT |
| 01 | — | 932689281050 | BLUE CROSS | UT |