Organization
OURAY FAMILY MEDICINE LLC
Active
Other names
Pavilion Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID P OLSON MD (OWNER)
(970) 249-6670
Entity
Organization
Contact information
Practice address
1804 E PAVILION PL, MONTROSE, CO 81401-5795
(970) 249-6670
(970) 252-1372
Mailing address
1804 E PAVILION PL, MONTROSE, CO 81401-5795
(970) 249-6670
(970) 252-1372
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89081251
—
CO
01
—
DS4766
RAILROAD WORKERS MEDICARE
—
Enumeration date
03/06/2009
Last updated
12/28/2016
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