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Contact Information

TAIT D OLAVESON, DO
3200 CHANNING WAY STE 206
IDAHO FALLS, ID83404-7546
 Phone: 208-529-2230
 Fax: 208-453-6142
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Undersea and Hyperbaric Medicine

2083P0011X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for TAIT D OLAVESON · (Male)

NPI # 1356518831
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 05/13/2008
Last updated 06/04/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • AK License # 179881
  • GA License # 82499
  • ID License # O-0726
  • MT License # 93936
  • WY License # 13411C
Hospital affiliation(s)
  • EASTERN IDAHO REGIONAL MEDICAL CENTER - (Acute Care)
    3100 CHANNING WAY
    IDAHO FALLS, ID 83404
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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