Larsen, Bruce D

Larsen, Bruce D is an individual health care provider with primary practice located at 2850 N 2000 W , Farr West UT 84404-9219. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Larsen, Bruce D can be contacted via phone (801) 377-5757.

Contact Information

Primary practice address
2850 N 2000 W Farr West UT 84404-9219
Phone: (801) 377-5757
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 49625291205 Utah

Profile Details

NPI number 1922189372
LBN Legal business name Larsen, Bruce D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jun 14th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922189372 NPPES
Utah MEDICAID 942854058001

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