Dr TAIT DELL OLAVESON is a male medical professional, specializing in General Surgery. He graduated in 2007 from Oklahoma College Of Osteopathic Medicine And Surgery.
BURN AND RECONSTRUCTIVE CENTERS OF IDAHO PLLC
3100 CHANNING WAY
IDAHO FALLS
ID
834047533
Tel: 7068639595
| Npi | 1356518831 |
| Pac Id | 2264610674 |
| Professional Enrollment Id | I20130927000464 |
| Last Name | OLAVESON |
| First Name | TAIT |
| Middle Name | DELL |
| Suffix | |
| Gender | M |
| Credential | |
| Medical School Name | OKLAHOMA COLLEGE OF OSTEOPATHIC MEDICINE AND SURGERY |
| Graduation Year | 2007 |
| Primary Specialty | GENERAL SURGERY |
| Secondary Specialty 1 | |
| Secondary Specialty 2 | |
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| Secondary Specialty 4 | |
| All Secondary Specialties | |
| Organization Legal Name | BURN AND RECONSTRUCTIVE CENTERS OF IDAHO PLLC |
| Group Practice Pac Id | 0042551244 |
| Number Of Group Practice Members | 6 |
| Line 1 Street Address | 3100 CHANNING WAY |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 834047533 |
| Phone Number | 7068639595 |
| Hospital Affiliation Ccn 1 | 130018 |
| Hospital Affiliation Lbn 1 | EASTERN IDAHO REGIONAL MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | 130065 |
| Hospital Affiliation Lbn 2 | MOUNTAIN VIEW HOSPITAL |
| Hospital Affiliation Ccn 3 | |
| Hospital Affiliation Lbn 3 | |
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| Professional Accepts Medicare Assignment | Y |
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