Individual
ERIC B OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1024 LEMAY AVENUE, FORT COLLINS, CO 80525
(970) 495-7711
Mailing address
DEPT 2215, DENVER, CO 80291-0001
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
34626
CO
207P00000X
Emergency Medicine Physician
Primary
34626
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01346261
—
CO
05
—
111255400
—
WY
01
—
666496
BCBS
CO
01
—
930034093
BCBS 2
—
01
—
P00064077
RAILROAD MEDICARE
CO
01
—
S5008
BCBS EPR
CO
Enumeration date
07/05/2006
Last updated
02/24/2011
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