Individual
ERIC JON OLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1211 W MAIN ST, WATERBURY, CT 06708-3106
(203) 755-0163
(203) 753-3415
Mailing address
1211 W MAIN ST, WATERBURY, CT 06708-3106
(203) 755-0163
(203) 753-3415
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
034638
CT
207X00000X
Orthopaedic Surgery Physician
Primary
034638
CT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
064638
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010034638CT01
BLUE CROSS
CT
01
—
034638
CONNECTICARE
CT
01
—
0R3416
HEALTHNET
CT
01
—
2305230
UNITED HC
CT
01
—
NHS540
OXFORD
CT
Enumeration date
09/25/2006
Last updated
03/24/2008
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