Individual
MARK R OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 6TH STREET, HUGO, CO 80821
(719) 743-2421
(719) 743-2084
Mailing address
PO BOX 248, HUGO, CO 80821-0248
(719) 743-2421
(719) 743-2084
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25806
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01258060
—
CO
Enumeration date
05/27/2005
Last updated
10/10/2012
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