Individual
DR. RUSSELL G OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1811 W ROYAL HUNTE DR, SUITE 2, CEDAR CITY, UT 84720-8273
(435) 586-2225
(435) 867-1909
Mailing address
1811 W ROYAL HUNTE DR, SUITE 2, CEDAR CITY, UT 84720-8273
(435) 586-2225
(435) 867-1909
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
106765-0501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1069500001
RR MEDICARE DME
UT
01
—
167286
DMBA
UT
01
—
528688204001
BLUECROSS PPO
UT
01
—
73654
INTERMOUNTAIN HEALTH CARE
UT
01
—
870545030006
MEDICAID DME
UT
01
—
870545030OL1
EDUCATORS MUTUAL
UT
Enumeration date
07/19/2005
Last updated
12/28/2007
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